BOF: 41
A thirty four year old female presents with a deep vein
thrombosis. She has a history of weight loss, recurrent mouth ulcers and
chronic diarrhoea with the passage of a bulky stool, which is difficult to
flush away. She has a macrocytic anaemia.
The underlying biochemical abnormality that would explain
the DVT would be:
a)
Vitamin B 12 deficiency
b)
Folic acid deficiency
c)
Iron deficiency
d)
Protein S deficiency
e)
Protein C deficiency
Answer:
b)
The patient has coeliac disease. In coeliac disease folic
acid deficiency with resultant hyper-homocystinaemia increases the tendency to
thromboembolic phenomena.
