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my personal edition > transfusion > news
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DGReview
Increased Pain, Swelling after Blood Donation May Indicate Deep Venous Thrombosis
A DGReview of :"Upper-extremity deep venous thrombosis complicating whole-blood donation"
Transfusion
04/12/2004
By Emma Hitt, PhD
Deep venous thrombosis should be considered when a blood donor presents with increasing pain and swelling after blood donation, a new case report indicates.
More than one third of blood donors may experience donation-related complications, such as fatigue, bruises, haematomas, and vasovagal reactions, but serious complications are rare, occurring with an estimated frequency of 0.0005 to 0.002% or less.
Randall B. Covin, PhD, with the University of Minnesota Medical School, in the Department of Laboratory Medicine and Pathology, Minneapolis, United States, and colleagues describe the case of a 20-year-old female-- a first-time donor--taking the third-generation oral contraceptive desogestrel/ethinyl estradiol and ethinyl estradiol (Mircette).
The donor was a non-smoker, and the answers on her donor questionnaire were unremarkable. Blood pressure was 130/70 mm Hg, pulse was 80 beats per minute, weight was 160 pounds, and temperature (T) was 98.6 F. Her predonation haematocrit was 40%.
For 5 days after donating blood, the patient developed bruising and increased pain and swelling of her right arm. The venipuncture was reported as being mildly traumatic. No personal or family history of thrombosis was reported. No thrombophilia was present, and the only risk factor for thrombosis was use of oral contraceptives.
A deep venous thrombosis was observed upon ultrasound examination of her upper extremity. The thrombosis required treatment with enoxaparin sodium for 5 days and warfarin for 6 months. Oral contraceptives were discontinued. Over the next 2 to 3 weeks, the bruising, haematoma, and swelling of her arm resolved.
Testing to exclude a hypercoagulable state was performed approximately 4 months after diagnosis. The patient had temporarily discontinued warfarin for 3 days before phlebotomy for these studies. The tests for inherited and acquired (lupus anticoagulant) risk factors for thrombosis were negative.
"Upper-extremity deep venous thrombosis is a serious condition with potentially life-threatening sequelae and should be considered in a donor with worsening pain and swelling in their donation arm," Dr. Covin and colleagues conclude. "Prompt referral for diagnosis and treatment may result in relief of symptoms and significantly decrease the risk of long-term sequelae," they add.
Transfusion 2004;44:586-90.
"Upper-extremity deep venous thrombosis complicating whole-blood donation"
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