Deep vein thrombosis in a tetraparesic patient with mental retardation: Case report and review of the literature

Objective: To report a case of deep vein thrombosis (DVT) in a tetraparesic patient, a member of a population in which DVT is reportedly rare. Case report: A 36-year old tetraparesic resident of a developmental centre suddenly developed swelling of one leg. Her plasma D-dimer level was 751 (normal < 500) ng ml(-1). A Doppler ultrasound revealed femoral vein thrombosis. She usually spent 10-12 hours daily in a chair. For menstrual problems, she had received oral contraceptives (OC) for 23 months. She had no other genetic or acquired predisposition to DVT. She was anti-coagulated for 6 months and the OC was discontinued. She recovered without complications. Her DVT was probably caused by her immobility, prolonged sitting and OC. Conclusion: DVT may develop in tetraparesic patients if they are exposed to additional prothrombotic factors. OC should be prescribed cautiously to such people. Relevant literature, prevention and treatment are discussed.