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Factor V Leiden

Christy L. Baggett, DO, Collin R. Jones, MD and George G.A. Pujalte, MD, FACSM Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Factor V Leiden is a genetic mutation at the activated protein C (APC) cleavage site on the factor V and Va molecule leading to the most common form of inherited thrombophilia.

  • System...

DIAGNOSIS

HISTORY

  • Previous thrombosis

  • Family history of thrombosis

PHYSICAL EXAM

  • Family history of factor V Leiden mutation

  • Findings suggestive of VTE in any form (DVT, PE, cerebral thrombosis): 10–26% of ...

TREATMENT

Only indicated if with thrombotic event 

GENERAL MEASURES

  • Like general VTE treatment, patients with factor V Leiden and a first thrombosis should be anticoagulated initially with heparin or lo...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Warfarin use requires periodic (~monthly after initial stabilization) INR measurements, with a goal of 2 to 3 (6)[A]. 

DIET

  • No restrictions

  • Large a...

REFERENCES

1
Dłuski D, Mierzyński R, Poniedziałek-Czajkowska E, et al. Adverse pregnancy outcomes and inherited thrombophilia. J Perinat Med.  2018;46(4):411–417. [View Abstract on OvidMedline]
2
Ro...

ADDITIONAL READING

Seligsohn U, Lubetsky A. Genetic susceptibility to venous thrombosis. N Engl J Med.  2001;344(16):1222–1231. [View Abstract on OvidMedline] 

SEE ALSO

Deep Vein Thrombophlebitis 

CODES

ICD10

D68.51 Activated protein C resistance 

ICD9

289.81 Primary hypercoagulable state 

SNOMED

  • 307091009 factor V Leiden mutation (disorder)

  • 307116001 Heterozygous Factor V Leiden mutation

  • 307115002 Ho...

CLINICAL PEARLS

  • Extremely rare in Asian and African populations

  • Asymptomatic patients with factor V Leiden do not need anticoagulation.

  • For pregnant women homozygous for factor V Leiden but no prior his...

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