Table of Contents
Thrombosis
Volume 2011, Article ID 785459, 4 pages
http://dx.doi.org/10.1155/2011/785459
Research Article

Venous Thrombosis in Multiple Sclerosis Patients after High-Dose Intravenous Methylprednisolone: The Preventive Effect of Enoxaparin

1Mehr Hospital, Shahid Beheshti University of Medical Sciences, Tehran 19857-17443, Iran
2Loghman Hospital, Shahid Beheshti University of Medical Sciences, Tehran 19857-17443, Iran
3Mehr Hospital, Shahid Beheshti University of Medical Sciences, Tehran 19857-17443, Iran
4Department of Cardiology, Faculty of Medicine Damascus University, P.O. Box 8487, Damascus, Syria

Received 16 August 2011; Revised 15 November 2011; Accepted 16 November 2011

Academic Editor: J. Harenberg

Copyright © 2011 Hossein Kalanie et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aim. This study was designed to examine the possible role of high-dose intravenous methylprednisolone (IVMP) in the development of venous thrombosis (VT). The cerebral one anecdotally had been reported in patients with relapsing remitting multiple sclerosis (RRMS) in acute attacks and the possible preventive role of enoxaparin. Material and Methods. From a pool of 520 patients, 388 patients with definite RRMS who fulfilled entry characteristics were selected and randomly received either a 5-day course of daily 1 gr IVMP or the aforementioned plus 5 days of daily subcutaneous 40 units of enoxaparin according to a predefined protocol. Results. Mean age, gender ratio, mean relapse rate, and EDSS were similar in both groups of patients (P > 0.05). Finally, 366 patients remained in the study. Of 188 patients treated with IVMP with 855 relapses, 5 developed VT (0.37% per patient per year and 0.58% per each course of IVMP) within 3 to 15 days of starting therapy. None of the 178 patients who experienced 809 relapses who received IVMP plus enoxaparin developed such complications. Conclusion. The study implies that high-dose IVMP in MS exacerbation may increase the risk of VT and prophylactic anticoagulant treatment in this setting is warranted.