Lower limb varicose veins as a manifestation of undifferentiated connective tissue dysplasia

Potapov M.P.¹, Potapov P.P.¹, Staver E.V.², Mazepina L.S.¹

1) Surgical Diseases Department of the Paediatric Faculty, Chair of Biological and General Chemistry, Yaroslavl State Medical University of the RF Public Health Ministry,
2) Railroad Clinical Hospital at the Yaroslavl station of the Open Joint-Stock Company "Russian Railways", Yaroslavl, Russia

Analysed herein are the data of 737 patients (a total of 745 lower limbs) suffering from lower-limb varicose veins (LLVV) and subjected to treatment at the Surgical Department consisting of crossectomy, truncal and tributary phlebectomy, dissection of perforant veins exclusively in the basin of the great saphenous vein. Relapses during five-year follow up occurred in 13.8% (102/745) of cases.

Based on clinical signs and laboratory findings we studied the effect of the factor of undifferentiated connective tissue dysplasia (UDCTD) on the development of lower-limb varicosity.

We carried out comparative analysis in the groups with relapsing LLVV (n=43), without relapses (n=39) and control group comprising volunteers not suffering from LLVV (n=37). The median of blood serum total oxiprolin concentration in LLVV patients both with and without relapses was elevated and amounted to 18.4 (IR 14.9–19.65) and 14.3 (IR 13.1–16.5) versus 8.35 (5.75–9.75) μmol/l, respectively. The mode of the clinical parameter of UDCTD degree in accordance with the rating scale of Smolnova T.Yu. (2003) in the group of patients with LLVV relapses turned out to be higher (Mo=19) than in the group of patients without relapses (Mo=10, p=0.003). The lowest score was in the control group. In patients having immediate relatives with LLVV the level of blood serum total oxiprolin and clinical scores of LLVV turned out to be statistically significantly higher.

Hence, based on the obtained during the study clinical and laboratory findings it may be supposed that undifferentiated connective tissue dysplasia plays an important part in the development of both lower limb varicosity and relapses thereof.

KEY WORDS: lower limb varicose veins, connective tissue dysplasia, oxiprolin, collagen.

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