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*Prothrombotic states which can be origin from venous or both venous and arterial clots might be classified into heritable, acquired or mixed resulting from the interactions between the environment (e.g. oestrogen use, obesity or other lifestyle factors) and genetic factors as elaborated in the following Table 1.<ref name=Hoffman1>Hoffman R, Benz EJ, Shattil SJ, et al. Hematology: Basic Principles and Practice: Elsevier Science Health Science Division; 2004.</ref><ref name="pmid24421360">{{cite journal| author=Cohoon KP, Heit JA| title=Inherited and secondary thrombophilia. | journal=Circulation | year= 2014 | volume= 129 | issue= 2 | pages= 254-7 | pmid=24421360 | doi=10.1161/CIRCULATIONAHA.113.001943 | pmc=3979345 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24421360  }} </ref>   
*Prothrombotic states which can be origin from venous or both venous and arterial clots might be classified into heritable, acquired or mixed resulting from the interactions between the environment (e.g. oestrogen use, obesity or other lifestyle factors) and genetic factors as elaborated in the following Table 1.<ref name=Hoffman1>Hoffman R, Benz EJ, Shattil SJ, et al. Hematology: Basic Principles and Practice: Elsevier Science Health Science Division; 2004.</ref><ref name="pmid24421360">{{cite journal| author=Cohoon KP, Heit JA| title=Inherited and secondary thrombophilia. | journal=Circulation | year= 2014 | volume= 129 | issue= 2 | pages= 254-7 | pmid=24421360 | doi=10.1161/CIRCULATIONAHA.113.001943 | pmc=3979345 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24421360  }} </ref>   


{| class="wikitable"
'''Table 1: Classification of thrombophilias'''
! colspan="3" style="text-align: center; font-weight: bold;" | Thrombophilia Classification
|-
| style="font-weight: bold; font-style: italic;" | Inherited (Primary)
| style="font-weight: bold; font-style: italic;" | Acquired (Secondary)
| style="font-weight: bold; font-style: italic;" | Mixed/Unknown
|-
| [[Activated protein C resistance]] ([[Factor V Leiden]])
| [[Age]]
| [[Hyperhomocysteinemia]]
|-
| [[Prothrombin]] gene mutation (Prothrombin G20210A)
| [[Immobilization]]
| APC resistance unrelated to Factor V Leiden.
|-
| [[Antithrombin deficiency]]
| [[Trauma]]/major surgery
| Increased [[Factor VIII]] levels
|-
| [[Protein C deficiency|Protein C]] and [[Protein S deficiency]]
| [[Orthopedic surgery]]
| Increased [[Factor XI]] levels
|-
| Dysfibrinogenemia
| [[Malignancy]]
| Increased [[Factor IX]] levels
|-
| Non-O [[blood type]]
| [[Myeloproliferative neoplasm|Myeloproliferative disorders]] ([[polycythemia vera]], [[essential thrombocythemia]], [[hyperviscosity]])
| Increased levels of [[thrombin-activatable fibrinolysis inhibitor]] (TAFI)
|-
|
| [[Pregnancy]]
| Decreased levels of free [[tissue factor pathway inhibitor]] (TFPI)
|-
|
| [[Estrogen]] and [[testosterone]] ([[oral contraceptive]]s, [[hormone replacement therapy]], and [[selective estrogen receptor modulator]])
|
|-
|
| [[Obesity]]
|
|-
|
| [[Heart Failure]]
|
|-
|
| [[Cirrhosis]]
|
|-
|
| [[Chronic renal disease]], [[Nephrotic syndrome]]
|
|-
|
| [[Antiphospholipid syndrome]] (APLS) or [[lupus anticoagulant]]
|
|-
|
| [[Heparin-induced thrombocytopenia]] (HIT)
|
|-
|
| [[Disseminated intravascular coagulopathy]] (DIC)
|
|-
|
| [[Paroxysmal nocturnal hemoglobinuria]] (PNH)
|
|-
|
| Autoimmune disorders ([[Vasculitis]], [[Celiac disease]], [[Inflammatory bowel disease]])
|
|-
|
| [[Thrombotic microangiopathy]]
|
|-
|
| [[Sickle cell disease]]
|
|-
|
| Drug related (chemotherapies including L-aspariginase, [[mitomycin]]; infusion of clotting factors including [[prothrombin]] complex concentrates, [[cryoprecipitate]]; drugs including [[hydralazine]], [[procainamide]], or [[phenothiazines]] can promote lupus anticoagulant formation)
|
|}


{| class="wikitable"
{| class="wikitable"
! style="text-align: center;" | Thrombophilic states associated with arterial clots
|-
| style="text-align: center;" | APLS and lupus anticoagulant
|-
|-
| style="text-align: center;" | HIT
! Type of classification !! Medical conditions
|-
|-
| style="text-align: center;" | DIC
|Inherited thrombophilia or primary hypercoagulable state || Example
|-
|-
| style="text-align: center;" | PNH
| Acquired thrombophilia or secondary hypercoagulable state || Example
|-
|-
| style="text-align: center;" | [[Cold_agglutinin_disease|Cold agglutinins]] (associated with [[Mycoplasma_pneumonia|mycoplasma infections]])
| Mixed/Unknown || Example
|-
|-
| style="text-align: center;" | Vasculitis
| arterial thrombotic disorders || Example
|-
| style="text-align: center;" | Hyperhomocysteinemia
|}
|}
*JAK2-positive MPNs like polycythemia vera and essential thrombocythemia are associated with arterial thrombotic disorders.


==References==
==References==

Revision as of 18:15, 22 February 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Asiri Ediriwickrema, M.D., M.H.S. [2]

Overview

Thrombophilia may be classified into three subtypes: inherited or primary hypercoagulable states, acquired or secondary hypercoagulable states, and mixed/unknown.[1][2]

Classification

  • Prothrombotic states which can be origin from venous or both venous and arterial clots might be classified into heritable, acquired or mixed resulting from the interactions between the environment (e.g. oestrogen use, obesity or other lifestyle factors) and genetic factors as elaborated in the following Table 1.[1][2]

Table 1: Classification of thrombophilias

Type of classification Medical conditions
Inherited thrombophilia or primary hypercoagulable state Example
Acquired thrombophilia or secondary hypercoagulable state Example
Mixed/Unknown Example
arterial thrombotic disorders Example

References

  1. ↑ 1.0 1.1 Hoffman R, Benz EJ, Shattil SJ, et al. Hematology: Basic Principles and Practice: Elsevier Science Health Science Division; 2004.
  2. ↑ 2.0 2.1 Cohoon KP, Heit JA (2014). "Inherited and secondary thrombophilia". Circulation. 129 (2): 254–7. doi:10.1161/CIRCULATIONAHA.113.001943. PMC 3979345. PMID 24421360.

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