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General Medicine

Antithrombin Deficiency

Christina S. Gutta, MD and Holly L. Baab, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Antithrombin is a protease inhibitor that inhibits multiple proteins in the coagulation cascade. Most notably, antithrombin inhibits thrombin (factor IIa) by forming an irreversible ...

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 (4),(5)[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

1
Lipe B, Ornstein DL. Deficiencies of natural anticoagulants, protein C, protein S, and antithrombin. Circulation.  2011;124(14):e365–e368. [View Abstract on OvidMedline]
2
Corral J, de ...

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

  • Patients deficient in antithrombin have an increased incidence of venous thrombosis, including DVT of the lower extremity. Arterial thrombosis is much less common in patients deficient...

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Related Images
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Figure 16-55 IVC UMBRELLA FILTER. A. AP Lumbar. B. Lateral Lumbar. This metallic umbrella fillter is placed in the inferior vena cava to capture emboli from the lower extremities in patients with thrombophlebitis.
Figure 16-55 IVC UMBRELLA FILTER. A. AP Lumbar. B. Lateral Lumbar. This metallic umbrella fillter is placed in the inferior vena cava to ca...
Figure 18-110DEEP VENOUS THROMBOSIS. A. Ultrasound,Lower Limb.Note the thrombus within the femoral vein (arrows). Failure of the vein to collapse from the compression of the ultra sound head confirms the presence of endoluminal thrombus (arrowheads). B. Pulmonary Embolism,Pulmonary CT Angiogram, Axial Chest.Observe the emboliin the pulmonary artery (arrow) and left atrium (arrow). COMMENT:Lower limb ultrasound evaluation is routinely p...
Figure 18-110DEEP VENOUS THROMBOSIS. A. Ultrasound,Lower Limb.Note the thrombus within the femoral vein (arrows). Failure of the vein to co...
FIGURE 24-15 Common sites of venous thrombosis. (A) Superficial thrombophlebitis. (B) Most common form of deep thrombophlebitis. (C and D) Deep thrombophlebitis from the calf to iliac veins.
FIGURE 24-15 Common sites of venous thrombosis. (A) Superficial thrombophlebitis. (B) Most common form of deep thrombophlebitis. (C and D) ...
Figure 13.28. Measurement of the lower extremity circumference. Increase in size is consistent with swelling, which might be due to a deep venous thrombosis.
Figure 13.28. Measurement of the lower extremity circumference. Increase in size is consistent with swelling, which might be due to a deep ...
Schematic of development of thrombus in deep vein
Schematic of development of thrombus in deep vein
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