A rare report of thrombophilic derangements related to migraine with aura in monozygotic twins.

Recent evidences indicate that migraine may be involved as a risk factor for cerebral infarction in young women, thus indicating an undisputable connection between migraine and cerebral ischaemia [1–3]. Although the nature of this connection remains essentially unknown, several studies have been devoted to the detection of markers of a prothrombotic tendency in migrainous subjects [1–4]. In the present study, we have evaluated the possible relationship between migraine and prothrombotic genetic risk factors. MN and MM, 52 year old monozygotic male twins, and MA 27-year old daughter of MM are suffering from migraine with aura (International Headache Society, 2004 criteria) since 15 years of age and have a familial history of cardio-cerebral vascular disease. MN is affected with angina pectoris and MM with myocardial infarction and transient ischemic accident. Data of laboratory examinations for screening of the prothrombotic state revelead: MN: Factor XI:c 128.2% (range 70–120), Factor XII:c 150.4% (range 70–120), Activated Protein C-resistance (APT) 0.6 (range >0.7), Plasma Homocysteine 29 mmol/L (range 5–15), MTHFR gene (TT/CC). MM: Factor XII:c 138.6% (range 70–120), APC-resistance 0.6 (range >0.7), Plasma Homocysteine 40.2 mmol/L (range 5–15), MTHFR gene (TT/CC). MA: Factor XII:c 132.2% (range 70–120), APC-resistance 0.5 (range >0.7), Plasma Homocysteine 30.6 mmol/L (range 5–15), MTHFR gene (TT/CC), PAI-1 4G/5G. Although there are no data in literature on prothrombotic genetic risk factors in patients suffering from migraine, our data seem to demonstrate a strict association between migraine with aura history, cardio-cerebral vascular disease and prothrombotic genetic risk factors, thus suggesting that haemostatic risk factors for arterial thrombosis could play an important role in the clinical study of these patients.