Q. The letter about the girl on the pill who developed blood clots in her brain caught my eye. At 21 my daughter was on the pill and being treated for bronchitis. She began having trouble breathing, fainted and ended up in the ER with blood clots in her lungs. Tests showed that she has a prothrombin gene mutation that, with estrogen, is a time bomb.
I recommend that the other girl get tested. My daughter was in the ICU for a week and on Coumadin for a year. If she gets pregnant, she will be a high-risk patient.
Estrogen Products Interacting with Genetic Susceptibility:
A. Estrogen in oral contraceptives or hormone replacement therapy interacts with certain genetic susceptibility factors to put women at higher risk for blood clots (Metabolism, March, 2001). Since estrogen rises naturally in pregnancy, your daughter would be at increased risk then (British Journal of Haematology, Oct., 2003).
There are several genetic variations that can put women at greater risk for blood clots when they take estrogen (Health Technology Assessment, April, 2006). A patient-oriented discussion of the Prothrombin 20210 mutation was published by Circulation (July, 2004). There is also a brochure for patients and their families available from the University of Iowa.
