Venous thrombosis in a replanted finger with underlying factor V Leiden mutation

Resistance to activated protein C (APC resistance) was described recently as a cause for thrombophilia.1 APC inactivates coagulation co-factors Va and VIIIa. A single base-pair mutation changing Arg506 to Gln at the APC cleavage site of the factor V gene leads to a factor V Leiden variant,2 which is the most frequent cause of APC resistance.3,4 Recently, its role in peripheral venous thrombosis during pregnancy was described.5 We here report a case with thrombosis of the venous anastomoses after finger replantation with resistance to activated protein C associated with factor V Leiden mutation.