Mechanisms
Case report: Lp(a) of 113 mg/dL behind recurrent deep vein thrombosis and cerebral venous sinus thrombosis across two pregnancies (Case Rep Neurol 2025)
Original title: High Lipoprotein (a) Levels Causing Recurrent Deep Vein Thrombosis and Cerebral Venous Sinus Thrombosis in Different Pregnancies: A Case Report
This case report describes a 29-year-old Nepalese woman who developed deep vein thrombosis (DVT) during her first pregnancy despite no identifiable thrombophilic predisposition, treated successfully with oral anticoagulation. During her second pregnancy, despite prophylactic subcutaneous heparin, she developed cerebral venous sinus thrombosis (CVST) after several days without heparin administration, presenting with left occipital pain and resolving with oral anticoagulants. Subsequent testing revealed an Lp(a) level of 113 mg/dL, well above the atherogenic threshold. The authors recommend that Lp(a) be measured in patients who develop venous thrombosis during pregnancy without another identifiable thrombophilic cause, and that long-term anticoagulation be considered in those with elevated Lp(a) to prevent recurrence.
Original abstract
Introduction: High levels of lipoprotein (a) [Lp (a)] have gained attention as a risk factor for venous thrombosis. Venous thrombosis during pregnancy in women without thrombophilic predisposition is attributed to pregnancy itself. Herein, we report a case of high Lp (a) levels manifesting as recurrent deep vein thrombosis (DVT) and cerebral venous sinus thrombosis (CVST) in different pregnancies.
Case Presentation: A 29-year-old Nepalese woman developed DVT during her first pregnancy. Examination revealed no thrombophilic predisposition. The thrombus resolved with oral anticoagulant medication, which was discontinued after 3 months. During the second pregnancy, prophylactic subcutaneous heparin injections were initiated to prevent venous embolism. Following several days of non-administration of heparin, she experienced left occipital pain, and magnetic resonance venogram showed left CVST. Oral anticoagulants were initiated, and her headache resolved within a few days. Additional blood tests showed abnormally high levels of Lp (a) at 113 mg/dL. Six months later, the CVST was partially recanalized.
Conclusion: If venous thrombosis develops during pregnancy in patients without thrombophilic predisposition, Lp (a) levels should be monitored, and long-term anticoagulant medication may be desirable in those with high Lp (a) levels to prevent recurrence of venous thrombosis.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.