Thrombophilia differential diagnosis: Difference between revisions
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==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]] | ||
**The most common inherited thrombophilias include [[Factor V Leiden]] and [http://emedicine.medscape.com/article/209742-overview Prothrombin G20210A] | |||
**The most common acquired thrombophilic states include [[surgery]], [[trauma]], or prolonged [[immobility]] | |||
**Refer to the [[Thrombophilia_classification|classification section]] for a complete description of various hypercoagulable states | |||
*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> | *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) | **Family history of thrombosis, especially at an early age (< 45 years) | ||
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**Recurrent thrombosis including [[Deep venous thrombosis]], [[Pulmonary embolus]], or superficial venous 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 at multiple sites, or unusual locations including in cerebral, hepatic, portal, mesenteric, and renal veins | ||
**Thrombosis in arteries with the | **Thrombosis in arteries with the abscence of [[Peripheral_arterial_disease|arterial disease]] | ||
**History of fetal loss | **History of fetal loss | ||
**History of [[Warfarin_necrosis|warfarin skin necrosis]] | **History of [[Warfarin_necrosis|warfarin skin necrosis]] | ||
==References== | ==References== | ||
Revision as of 04:11, 21 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
- The most common inherited thrombophilias include Factor V Leiden and Prothrombin G20210A
- The most common acquired thrombophilic states include surgery, trauma, or prolonged immobility
- Refer to the classification section for a complete description of various hypercoagulable states
- 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.