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Thrombophilia and Hypercoagulable States

Reviewed 06/2019
 


BASICS

DESCRIPTION

  • An inherited or acquired disorder of the coagulation system predisposing an individual to thromboembolism (the formation of a venous, or less commonly, an arterial blood clot)

  • Venous ...

DIAGNOSIS

HISTORY

Consider prothrombotic assessment for the following: 
  • Thrombosis at an unusual anatomic site or recurrent thromboses

  • Family history suggesting multiple individuals affected with VTE

  • Recu...

TREATMENT

MEDICATION

First Line

  • Newer oral anticoagulants: Apixaban, dabigatran, edoxaban, and rivaroxaban are now recommended over vitamin K antagonists for long-term oral anticoagulation (5)[B].

  • Parent...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Avoid significant risk for trauma (e.g., contact sports, climbing a ladder). 

Patient Monitoring

Monitor warfarin as frequently as needed to maintain an INR goal of...

REFERENCES

1
Heit J. Epidemiology of venous thromboembolism. Nat Rev Cardiol.  2015;12(8):464–474. [View Abstract on OvidMedline]
2
Baglin T, Gray E, Greaves M, et al; for British Committee for Stan...

ADDITIONAL READING

Stevens SM, Woller SC, Bauer KA, et al. Guidance for the evaluation and treatment of hereditary and acquired thrombophilia. J Thromb Thrombolysis.  2016;41(1):154–164. [View Ab...

CODES

ICD10

  • D68.59 Other primary thrombophilia

  • D68.51 Activated protein C resistance

  • D68.2 Hereditary deficiency of other clotting factors

  • D68.8 Other specified coagulation defects

  • D53.0 Protein deficiency...

CLINICAL PEARLS

  • Factor V Leiden (resistance to aPC) is the most common inherited thrombophilia, with a prevalence of 2–7% in the U.S. Caucasian population.

  • Test patients for thrombophilias only if it w...

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