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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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