Thrombophilia classification: Difference between revisions
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==Overview== | ==Overview== | ||
Thrombophilias may be classified into three groups: '''inherited or primary hypercoagulable states''', '''acquired or secondary hypercoagulable states''', | Thrombophilias may be classified into three groups: '''inherited or primary hypercoagulable states''', '''acquired or secondary hypercoagulable states''', and '''mixed/unknown'''. Certain conditions are associated with greater [[thrombotic]] risks and both venous and arterial clots. | ||
==Classification== | ==Classification== |
Revision as of 14:44, 19 July 2016
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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
Thrombophilias may be classified into three groups: inherited or primary hypercoagulable states, acquired or secondary hypercoagulable states, and mixed/unknown. Certain conditions are associated with greater thrombotic risks and both venous and arterial clots.
Classification
- Inherited thrombophilia or primary hypercoagulable state
- Acquired thrombophilia or secondary hypercoagulable state
- Mixed/Unknown
- Different thrombophilic states are associated with venous or both venous and arterial clots.
Thrombophilia Classification | ||
---|---|---|
Inherited (Primary) | Acquired (Secondary) | Mixed/Unknown |
Activated protein C (APC) 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 and protein S deficiency | Orthopedic surgery | Increased factor XI levels |
Dysfibrinogenemia | Malignancy | Increased factor IX levels |
Non-O blood type | 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 contraceptives, 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's 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) |
Thrombophilic states associated with arterial clots |
---|
APLS and lupus anticoagulant |
HIT |
DIC |
PNH |
Cold agglutinins (associated with mycoplasma infections) |
Vasculitis |
Hyperhomocysteinemia |
References
- ↑ Hoffman R, Benz EJ, Shattil SJ, et al. Hematology: Basic Principles and Practice: Elsevier Science Health Science Division; 2004.
- ↑ Cohoon KP, Heit JA (2014). "Inherited and secondary thrombophilia". Circulation. 129 (2): 254–7. doi:10.1161/CIRCULATIONAHA.113.001943. PMC 3979345. PMID 24421360.