Thrombophilia: Difference between revisions
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In [[hematology]], '''thrombophilia''', also called '''hypercoagulability''', is "a disorder of [[hemostasis]] in which there is a tendency for the occurrence of [[thrombosis]]."<ref>{{MeSH}}</ref> | In [[hematology]], '''thrombophilia''', also called '''hypercoagulability''', is "a disorder of [[hemostasis]] in which there is a tendency for the occurrence of [[thrombosis]]."<ref>{{MeSH}}</ref> | ||
==Clinical== | ==Clinical== | ||
===Recurrent embolism and thrombosis=== | ===Recurrent embolism and thrombosis=== | ||
{{main|Embolism and thrombosis}} | {{main|Embolism and thrombosis}} | ||
Examples include prothrombin gene G-->A20210 mutation.<ref name="pmid9669991">{{cite journal| author=Margaglione M, Brancaccio V, Giuliani N, D'Andrea G, Cappucci G, Iannaccone L et al.| title=Increased risk for venous thrombosis in carriers of the prothrombin G-->A20210 gene variant. | journal=Ann Intern Med | year= 1998 | volume= 129 | issue= 2 | pages= 89-93 | pmid=9669991 | doi= | pmc= | url= }} </ref> | |||
===Habitual abortion=== | ===Habitual abortion=== | ||
{| class="wikitable" align="right" | {| class="wikitable" align="right" | ||
|+ | |+ Thrombophilia and [[habitual abortion]].<ref name="pmid12648968">{{cite journal| author=Rey E, Kahn SR, David M, Shrier I| title=Thrombophilic disorders and fetal loss: a meta-analysis. | journal=Lancet | year= 2003 | volume= 361 | issue= 9361 | pages= 901-8 | pmid=12648968 | ||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=12648968 | doi=10.1016/S0140-6736(03)12771-7 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=12648968 | doi=10.1016/S0140-6736(03)12771-7 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | ||
! rowspan="2"| !! colspan="2"| [[Odds ratio]] | ! rowspan="2"| !! colspan="2"| [[Odds ratio]] | ||
|- | |- | ||
! Early pregnancy loss!! Late pregnancy loss | ! Early pregnancy loss<br/>(before 13 weeks)!!valign="top"|Late pregnancy loss | ||
|- | |- | ||
| [[Factor V Leiden]]|| 2.01 ([[Confidence interval|95% CI]] 1.13-3.58)||7.83 ([[Confidence interval|95% CI]] 2.83-21.67) | | [[Factor V Leiden]]|| 2.01 ([[Confidence interval|95% CI]] 1.13-3.58)||7.83 ([[Confidence interval|95% CI]] 2.83-21.67) | ||
|- | |- | ||
| Prothrombin G20210A|| 2.56 ([[Confidence interval|95% CI]] 1.04-.29)|| 2.30 ([[Confidence interval|95% CI]] 1.09-4.87)<br/> (non-recurrent) | | Prothrombin G20210A||valign="top"|2.56 ([[Confidence interval|95% CI]] 1.04-.29)|| 2.30 ([[Confidence interval|95% CI]] 1.09-4.87)<br/> (non-recurrent) | ||
|- | |- | ||
| [[Protein C]] deficiency||colspan="2" align="center"|No association | | [[Protein C]] deficiency||colspan="2" align="center"|No association | ||
| Line 25: | Line 27: | ||
| [[Protein S]] deficiency|| ||7.39 ([[Confidence interval|95% CI]] 1.28-42.63)<br/>(nonrecurrent) | | [[Protein S]] deficiency|| ||7.39 ([[Confidence interval|95% CI]] 1.28-42.63)<br/>(nonrecurrent) | ||
|- | |- | ||
| [[Methylenetetrahydrofolate]] mutation||colspan="2" align="center"|No association | | [[Methylenetetrahydrofolate reductase]] mutation||colspan="2" align="center"|No association | ||
|- | |- | ||
| [[Antithrombin]] deficiencies ||colspan="2" align="center"|No association | | [[Antithrombin]] deficiencies ||colspan="2" align="center"|No association | ||
|} | |} | ||
Thrombophilia have an increased risk of fetal loss, especially stillbirth after 28 weeks of gestation as opposed to miscarriage ([[spontaneous abortion]]) before 28 weeks of gestation<ref name="pmid8843809">{{cite journal| author=Preston FE, Rosendaal FR, Walker ID, Briët E, Berntorp E, Conard J et al.| title=Increased fetal loss in women with heritable thrombophilia. | journal=Lancet | year= 1996 | volume= 348 | issue= 9032 | pages= 913-6 | pmid=8843809 | |||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8843809 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | |||
[[Habitual abortion]], the occurrence of three or more [[spontaneous abortion]]s may be due to thrombophilia.<ref name="pmid12648968">{{cite journal| author=Rey E, Kahn SR, David M, Shrier I| title=Thrombophilic disorders and fetal loss: a meta-analysis. | journal=Lancet | year= 2003 | volume= 361 | issue= 9361 | pages= 901-8 | pmid=12648968 | [[Habitual abortion]], the occurrence of three or more [[spontaneous abortion]]s may be due to thrombophilia.<ref name="pmid12648968">{{cite journal| author=Rey E, Kahn SR, David M, Shrier I| title=Thrombophilic disorders and fetal loss: a meta-analysis. | journal=Lancet | year= 2003 | volume= 361 | issue= 9361 | pages= 901-8 | pmid=12648968 | ||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=12648968 | doi=10.1016/S0140-6736(03)12771-7 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=12648968 | doi=10.1016/S0140-6736(03)12771-7 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | ||
The benefit of adding treatment with [[low molecular weight heparin]] to patients already taking aspirin is not clear.<ref name="pmid19208560">{{cite journal| author=Laskin CA, Spitzer KA, Clark CA, Crowther MR, Ginsberg JS, Hawker GA et al.| title=Low molecular weight heparin and aspirin for recurrent pregnancy loss: results from the randomized, controlled HepASA Trial. | journal=J Rheumatol | year= 2009 | volume= 36 | issue= 2 | pages= 279-87 | pmid=19208560 | |||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19208560 | doi=10.3899/jrheum.080763) }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | |||
==References== | ==References== | ||
<references/> | <references/> | ||
Latest revision as of 14:32, 12 November 2010
In hematology, thrombophilia, also called hypercoagulability, is "a disorder of hemostasis in which there is a tendency for the occurrence of thrombosis."[1]
Clinical
Recurrent embolism and thrombosis
Examples include prothrombin gene G-->A20210 mutation.[2]
Habitual abortion
| Odds ratio | ||
|---|---|---|
| Early pregnancy loss (before 13 weeks) |
Late pregnancy loss | |
| Factor V Leiden | 2.01 (95% CI 1.13-3.58) | 7.83 (95% CI 2.83-21.67) |
| Prothrombin G20210A | 2.56 (95% CI 1.04-.29) | 2.30 (95% CI 1.09-4.87) (non-recurrent) |
| Protein C deficiency | No association | |
| Activated protein C resistance | 3.48 (95% CI 1.58-7.69) | |
| Protein S deficiency | 7.39 (95% CI 1.28-42.63) (nonrecurrent) | |
| Methylenetetrahydrofolate reductase mutation | No association | |
| Antithrombin deficiencies | No association | |
Thrombophilia have an increased risk of fetal loss, especially stillbirth after 28 weeks of gestation as opposed to miscarriage (spontaneous abortion) before 28 weeks of gestation[4]
Habitual abortion, the occurrence of three or more spontaneous abortions may be due to thrombophilia.[3]
The benefit of adding treatment with low molecular weight heparin to patients already taking aspirin is not clear.[5]
References
- ↑ Anonymous (2024), Thrombophilia (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Margaglione M, Brancaccio V, Giuliani N, D'Andrea G, Cappucci G, Iannaccone L et al. (1998). "Increased risk for venous thrombosis in carriers of the prothrombin G-->A20210 gene variant.". Ann Intern Med 129 (2): 89-93. PMID 9669991. [e]
- ↑ 3.0 3.1 Rey E, Kahn SR, David M, Shrier I (2003). "Thrombophilic disorders and fetal loss: a meta-analysis.". Lancet 361 (9361): 901-8. DOI:10.1016/S0140-6736(03)12771-7. PMID 12648968. Research Blogging.
- ↑ Preston FE, Rosendaal FR, Walker ID, Briët E, Berntorp E, Conard J et al. (1996). "Increased fetal loss in women with heritable thrombophilia.". Lancet 348 (9032): 913-6. PMID 8843809.
- ↑ Laskin CA, Spitzer KA, Clark CA, Crowther MR, Ginsberg JS, Hawker GA et al. (2009). "Low molecular weight heparin and aspirin for recurrent pregnancy loss: results from the randomized, controlled HepASA Trial.". J Rheumatol 36 (2): 279-87. DOI:10.3899/jrheum.080763). PMID 19208560. Research Blogging.