Ischemic colitis and acquired resistance to activated protein C in a woman using oral contraceptives

Am J Gastroenterol. 1998 Oct;93(10):1960-2. doi: 10.1111/j.1572-0241.1998.00555.x.


We present the case history of a 22-yr-old woman diagnosed with ischemic colitis associated with the use of oral contraceptives (OC). At the time of her presenting symptoms activated protein C (APC) resistance, a risk factor for thrombosis, was demonstrated. There was no laboratory evidence of inherited thrombophilia; that is, antithrombin III, protein C and protein S levels were normal and the factor V Leiden mutation was not present. The OC were discontinued and the patient's symptoms improved. Subsequent evaluation revealed that the activated protein C resistance had resolved. This case illustrates APC resistance as a potential link between OC use and its known association with ischemic colitis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Blood Coagulation Tests
  • Colitis, Ischemic / blood
  • Colitis, Ischemic / chemically induced*
  • Contraceptives, Oral, Combined / adverse effects*
  • Ethinyl Estradiol-Norgestrel Combination / adverse effects*
  • Factor V / genetics
  • Female
  • Humans
  • Mutation
  • Protein C* / physiology


  • Contraceptives, Oral, Combined
  • Protein C
  • factor V Leiden
  • Ethinyl Estradiol-Norgestrel Combination
  • Factor V