Antithrombin Deficiency

Patrick T. Murray, MD and Holly L. Baab, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Antithrombin is a glycoprotein that inhibits thrombin by forming an irreversible complex.

  • There are two active sites: one that binds to heparin and one that binds to thrombin/target e...

DIAGNOSIS

HISTORY

  • Previous thrombosis

  • Family history of thrombosis

  • Family history of antithrombin deficiency

  • Recurrent pregnancy loss

PHYSICAL EXAM

Signs consistent with a deep or superficial venous thrombo...

TREATMENT

GENERAL MEASURES

Routine anticoagulation for asymptomatic patients with antithrombin deficiency is not recommended (3,4)[C]. 

MEDICATION

First Line

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Warfarin use requires periodic INR measurements (monthly after initial stabilization) with a goal of 2 to 3. 

DIET

Foods high in vitamin K may int...

REFERENCES

Lipe B, Ornstein DL. Deficiencies of natural anticoagulants, protein C, protein S, and antithrombin. Circulation.  2011;124(14):e365–e368.  [View Abstract]
Maclean PS, Tait RC. Heredi...

ADDITIONAL READING

  • De Stefano V, Rossi E. Testing for inherited thrombophilia and consequences for antithrombotic prophylaxis in patients with venous thromboembolism and their relatives. A review of t...

SEE ALSO

Deep Vein Thrombophlebitis 

CODES

ICD10

D68.59 Other primary thrombophilia 

ICD9

  • 289.81 Primary hypercoagulable state

SNOMED

CLINICAL PEARLS

  • Antithrombin levels will be low on heparin and during acute thrombosis.

  • Diagnosis can be difficult. Conditions causing low levels of antithrombin III, such as pregnancy, liver disease, ...

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