Thrombophilia differential diagnosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Thrombophilia}} | {{Thrombophilia}} | ||
{{CMG}} | {{CMG}} {{AE}} {{asiri}} | ||
==Overview== | ==Overview== | ||
Inherited thrombophilia must be differentiated from acquired thrombophilia, as it may influence the selection and duration of [[Anticoagulant|anticoagulation]]. Inherited thrombophilias should be suspected in patients with the certain [[Thrombophilia_history_and_symptoms|clinical presentations]].<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><ref name="pmid11309638">{{cite journal| author=Seligsohn U, Lubetsky A| title=Genetic susceptibility to venous thrombosis. | journal=N Engl J Med | year= 2001 | volume= 344 | issue= 16 | pages= 1222-31 | pmid=11309638 | doi=10.1056/NEJM200104193441607 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11309638 }} </ref> | Inherited thrombophilia must be differentiated from acquired thrombophilia, as it may influence the selection and duration of [[Anticoagulant|anticoagulation]]. Inherited thrombophilias should be suspected in patients with the certain [[Thrombophilia_history_and_symptoms|clinical presentations]].<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><ref name="pmid11309638">{{cite journal| author=Seligsohn U, Lubetsky A| title=Genetic susceptibility to venous thrombosis. | journal=N Engl J Med | year= 2001 | volume= 344 | issue= 16 | pages= 1222-31 | pmid=11309638 | doi=10.1056/NEJM200104193441607 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11309638 }} </ref> [[Thrombophilia screening|Screening]] for inherited thrombophilias is controversial and should be performed in the appropriate clinical context.<ref name="pmid21340752">{{cite journal| author=Middeldorp S| title=Evidence-based approach to thrombophilia testing. | journal=J Thromb Thrombolysis | year= 2011 | volume= 31 | issue= 3 | pages= 275-81 | pmid=21340752 | doi=10.1007/s11239-011-0572-y | pmc=3056012 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21340752 }} </ref> | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
*Inherited thrombophilia must be differentiated from acquired thrombophilia, as it may influence the selection and duration of [[Anticoagulant|anticoagulation]] | *Inherited thrombophilia must be differentiated from acquired thrombophilia, as it may influence the selection and duration of [[Anticoagulant|anticoagulation]] | ||
*Inherited thrombophilias should be suspected in patients with the | *Inherited thrombophilias should be suspected in patients with the following clinical presentations:<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><ref name="pmid11309638">{{cite journal| author=Seligsohn U, Lubetsky A| title=Genetic susceptibility to venous thrombosis. | journal=N Engl J Med | year= 2001 | volume= 344 | issue= 16 | pages= 1222-31 | pmid=11309638 | doi=10.1056/NEJM200104193441607 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11309638 }} </ref> | ||
**Family history of thrombosis, especially at an early age (< 45 years) | |||
**Unprovoked thrombosis at an early age (<40-55 for venous thrombosis and <50-55 for arterial thrombosis) | |||
**Recurrent thrombosis including [[Deep venous thrombosis]], [[Pulmonary embolus]], or superficial venous thrombosis | |||
**Thrombosis at multiple sites, or unusual locations including in cerebral, hepatic, portal, mesenteric, and renal veins | |||
**Thrombosis in arteries with the abscence of [[Peripheral_arterial_disease|arterial disease]] | |||
**History of fetal loss | |||
**History of [[Warfarin_necrosis|warfarin skin necrosis]] | |||
==References== | ==References== | ||
Revision as of 18:56, 20 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
Inherited thrombophilia must be differentiated from acquired thrombophilia, as it may influence the selection and duration of anticoagulation. Inherited thrombophilias should be suspected in patients with the certain clinical presentations.[1][2] Screening for inherited thrombophilias is controversial and should be performed in the appropriate clinical context.[3]
Differential Diagnosis
- Inherited thrombophilia must be differentiated from acquired thrombophilia, as it may influence the selection and duration of anticoagulation
- Inherited thrombophilias should be suspected in patients with the following clinical presentations:[1][2]
- Family history of thrombosis, especially at an early age (< 45 years)
- Unprovoked thrombosis at an early age (<40-55 for venous thrombosis and <50-55 for arterial thrombosis)
- Recurrent thrombosis including Deep venous thrombosis, Pulmonary embolus, or superficial venous thrombosis
- Thrombosis at multiple sites, or unusual locations including in cerebral, hepatic, portal, mesenteric, and renal veins
- Thrombosis in arteries with the abscence of arterial disease
- History of fetal loss
- History of warfarin skin necrosis
References
- ↑ 1.0 1.1 Cohoon KP, Heit JA (2014). "Inherited and secondary thrombophilia". Circulation. 129 (2): 254–7. doi:10.1161/CIRCULATIONAHA.113.001943. PMC 3979345. PMID 24421360.
- ↑ 2.0 2.1 Seligsohn U, Lubetsky A (2001). "Genetic susceptibility to venous thrombosis". N Engl J Med. 344 (16): 1222–31. doi:10.1056/NEJM200104193441607. PMID 11309638.
- ↑ Middeldorp S (2011). "Evidence-based approach to thrombophilia testing". J Thromb Thrombolysis. 31 (3): 275–81. doi:10.1007/s11239-011-0572-y. PMC 3056012. PMID 21340752.