Hyperhomocysteinemia and deep vein thrombosis in orthotopic heart transplantation: A case report

Homocysteine has been recognized as a risk factor for atherosclerosis and arterial and venous thrombosis. Heart transplant patients have an increased prevalence of hyperhomocysteinemia. High homocysteine levels in transplant patients may promote development of cardiac allograft vasculopathy, but there is minimal information regarding the risk of venous thrombosis. The current case report illustrates the association of increased levels of homocysteine and hypercoagulable syndrome in a 36-year-old heart transplant patient with no previous history of clotting disorder. Both elevated homocysteine levels and extensive venous thrombosis responded promptly to treatment with a folate/B ₁₂/B₆ vitamin combination andenoxaparin.