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PAPERS: Kees van Grootheest and Tom Vrieling Drug points: Thromboembolism associated with the new contraceptive Yasmin BMJ 2003; 326: 257 [Full text]

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Thrombophilia and Prothrombin 20210 AG genotype

Honey M Mathew, JC Tony, Specialist Registrar in Medicine   (2 February 2003)

Pulmonary Embolism due to Yasmin

Tiffany (not disclosed)   (12 July 2003)

Thrombophilia and Prothrombin 20210 AG genotype 2 February 2003
Honey M Mathew, Specialist Registrar, Obstetrics and Gynaecology Mid Staffordshire General Hospital, ST16 3SA, JC Tony, Specialist Registrar in Medicine Send response to journal: Re: Thrombophilia and Prothrombin 20210 AG genotype	Editor, We read the case reports of thromboembolism reported to the Dutch spontaneous reporting system for adverse drug reactions following the use of the new oral contraceptive pill,Yasmin (1). The prothrombin 20210 A allele has been found to be associated with an increased risk of venous thrombosis for all ages and both sexes.There is an association between 20210 A allele and elevated prothrombin level. It has been observed that 87%of individuals with 20210 A allele are in the highest quartile of plasma prothombin level.Elevated prothrombin level itself is a risk factor for venous thrombosis (2).It will be useful to include prothombin gene studies in addition to the routine thrombophilia scren as mentioned by Grootheest et al,when adverse events like this are reported. REFERENCES 1 Grootheest K V, Vrieling T.Thromboembolism associated with the new contraceptive Yasmin.BMJ 2003;326:257. 2 Poort SR,Rosendaal FR,Reitsma PH,Bertina RM.A common genetic variation in the 3'-untranslated region of the prothrombin gene is associated with elevated plasma prothrombin levels and an increase in venous thrombosis.Blood 1996;88:3698-703. Competing interests:   None declared
Pulmonary Embolism due to Yasmin 12 July 2003
Tiffany (not disclosed), None None 85050 Send response to journal: Re: Pulmonary Embolism due to Yasmin	I am a 29 year old woman in good health and have taken Yasmin for less than 1 year. Also, I began smoking on a part-time basis, very lightly, approximately 4 cigarrettes a day if that and that is only since February of this year. Imagine my surprise when I suddenly had agonizing pain breathing and ended up in the hospital for 8 days because of a pulmonary embolism. I have no known genetic markers for the condition and have not had any travel recently. The only explanation found by my Doctors was the Yasmin. I have been told I was very lucky and I know how close I came to death. I know many people who smoke large amounts and have taken birth control for years...it is my strong opinion that this drug is too new and more dangerous than the FDA anticipated, and I think a closer look should be taken at the extremely serious risks of taking it. Competing interests:   None declared Editorial note: We know the full name of Tiffany but have agreed to publish only her first name.