It is estimated that 30-50% of patients suffering from deep vein thrombosis (DVT) could be diagnosed with congenital or acquired thrombophilia. Its diagnosis, however, rarely changes the clinical management, but is associated with significant costs and negative psychological and social aspects. The aim of this study was to perform a retrospective analysis of the causes and clinical consequences of diagnostics for thrombophilia. A retrospective review of the medical records of 5600 patients was performed, 62 of whom had, at the time, been diagnosed for thrombophilia because of a thromboembolic event. A review of the current literature on the validity of diagnostic tests for hypercoagulability in certain clinical conditions was also performed. The most common reason for thrombophilia testing was episodes of lower limb DVT (56%). The most frequently diagnosed abnormalities were the heterozygous form of the V Leiden gene (18%), protein S deficiency (11%), and the anti cardiolipin antibody IgG (11%). In 45% of the patients, laboratory results did not confirm the presence of any congenital thrombophilia. After receiving the results, 11% of the respondents completed oral anticoagulation therapy after 3 months, and 28% of patients qualified for indefinite use of oral anticoagulant therapy. In most of the cases examined, the diagnosis of thrombophilia did not significantly affect the treatment. A common aberration identified in patients with a history of thromboembolic incidents was the coexistence of risk factors for atherosclerosis.
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http://dx.doi.org/10.1097/MBC.0000000000000332 | DOI Listing |
Cureus
December 2024
Pulmonary and Critical Care, Jackson Memorial Hospital, Miami, USA.
Cancer and antiphospholipid syndrome (APS) independently increase thrombotic risk, and their coexistence can create a particularly hazardous prothrombotic state. This case report aims to highlight the complex challenges in managing concurrent thrombotic and hemorrhagic events in patients with a history of cancer and APS. The combination of these conditions presents a rare and difficult clinical scenario, requiring careful consideration in anticoagulation management.
View Article and Find Full Text PDFActa Med Indones
October 2024
1. Doctoral Program in Medical Science, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia. 2. Neuro-ophthalmology Division, Department of Ophthalmology, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia..
Background: Studies regarding hypercoagulation in Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION) patients have produced conflicting results. With a presumption that the early coagulation phase may affect the occurrence of NAION, this study aims to investigate the early coagulation markers, E-selectin and P-selectin, to determine whether these biomolecular changes play a significant role in NAION, thus potentially leading to a better clinical approach.
Methods: A cross-sectional study involving two groups of NAION subjects, a hypercoagulation group and a non-hypercoagulation group, was conducted in the Neuro-Ophthalmology Division, Department of Ophthalmology, FKUI-RSCM Kirana from October 2020 to April 2022.
Cells
January 2025
Research Department, Sidra Medicine, Doha P.O. Box 26999, Qatar.
Hemophilia A (HA) is associated with FVIII coagulation insufficiency or inactivity leading to excessive bleeding. Elevated FVIII, on the contrary, is associated with thrombophilia, thrombosis, myocardial infarctions, and stroke. Active FVIII (aFVIII) uses its C2 domain to bind to blood cells' membranes, consequently carrying out its coagulative function.
View Article and Find Full Text PDFBackground: When haemolytic anaemia, thrombocytopenia and renal failure are present, a thrombotic microangiopathic (TMA) condition should be suspected. We describe the various differential diagnoses of primary TMA syndromes, their clinical findings, clinical workup and treatment.
Case Presentation: A previously healthy man in his fifties was hospitalised with anaemia, thrombocytopenia, bilirubinaemia and acute renal failure.
Front Neurol
January 2025
Department of Neurology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.
We theorize that the southeastern United States has a higher stroke mortality rate and higher recurrent ischemic stroke rate than the rest of the United States due to (1) an increased prevalence of hypercoagulable states among young adults in the region, (2) failure to diagnose hypercoagulable states as the cause of ischemic stroke in young adults, and (3) underutilization of anticoagulation for ischemic stroke secondary prevention in young adults with hypercoagulable states. In an attempt to investigate this hypothesis, we conducted a retrospective chart review of 311 inpatients with first-ever ischemic stroke from age 18 to 55 years at an Oklahoma academic medical center from 1 July 2011 to 30 April 2017. Using Chi-squared test, we compared the stroke etiologic diagnosis of the attending neurologist at discharge-when hypercoagulable profile results were rarely available-to the diagnosis of a vascular neurologist postdischarge who had access to all available etiologic test results.
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