Thrombophilia classification: Difference between revisions
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==Overview== | ==Overview== | ||
Thrombophilia may be classified into three subtypes: '''inherited or primary hypercoagulable states''', '''acquired or secondary hypercoagulable states''', and '''mixed/unknown'''.<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> | |||
==Classification== | ==Classification== | ||
*Thrombophilia | *Thrombophilia may be classified into three subtypes:<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> | ||
:*Inherited thrombophilia or primary hypercoagulable state | :*Inherited thrombophilia or primary hypercoagulable state | ||
:*Acquired thrombophilia or secondary hypercoagulable state | :*Acquired thrombophilia or secondary hypercoagulable state | ||
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| style="font-weight: bold; font-style: italic;" | Mixed/Unknown | | style="font-weight: bold; font-style: italic;" | Mixed/Unknown | ||
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| Activated protein C | | [[Activated protein C resistance]] ([[Factor V Leiden]]) | ||
| Age | | [[Age]] | ||
| Hyperhomocysteinemia | | [[Hyperhomocysteinemia]] | ||
|- | |- | ||
| Prothrombin gene mutation (Prothrombin G20210A) | | [[Prothrombin]] gene mutation (Prothrombin G20210A) | ||
| Immobilization | | [[Immobilization]] | ||
| APC resistance unrelated to Factor V Leiden. | | APC resistance unrelated to Factor V Leiden. | ||
|- | |- | ||
| Antithrombin deficiency | | [[Antithrombin deficiency]] | ||
| Trauma/major surgery | | [[Trauma]]/major surgery | ||
| Increased | | Increased [[Factor VIII]] levels | ||
|- | |- | ||
| Protein C and | | [[Protein C deficiency|Protein C]] and [[Protein S deficiency]] | ||
| Orthopedic surgery | | [[Orthopedic surgery]] | ||
| Increased | | Increased [[Factor XI]] levels | ||
|- | |- | ||
| Dysfibrinogenemia | | Dysfibrinogenemia | ||
| Malignancy | | [[Malignancy]] | ||
| Increased | | Increased ]]Factor IX]] levels | ||
|- | |- | ||
| Non-O blood type | | Non-O [[blood type]] | ||
| Myeloproliferative disorders (polycythemia vera, essential thrombocythemia, hyperviscosity) | | [[Myeloproliferative neoplasm|Myeloproliferative disorders]] ([[polycythemia vera]], [[essential thrombocythemia]], [[hyperviscosity]]) | ||
| Increased levels of thrombin-activatable fibrinolysis inhibitor (TAFI) | | Increased levels of [[thrombin-activatable fibrinolysis inhibitor]] (TAFI) | ||
|- | |- | ||
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| Pregnancy | | [[Pregnancy]] | ||
| Decreased levels of free tissue factor pathway inhibitor (TFPI) | | Decreased levels of free [[tissue factor pathway inhibitor]] (TFPI) | ||
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| Estrogen and testosterone (oral | | [[Estrogen]] and [[testosterone]] ([[oral contraceptive]]s, [[hormone replacement therapy]], and [[selective estrogen receptor modulator]]) | ||
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| Obesity | | [[Obesity]] | ||
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| Heart Failure | | [[Heart Failure]] | ||
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| Cirrhosis | | [[Cirrhosis]] | ||
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|- | |- | ||
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| Chronic renal disease | | [[Chronic renal disease]], [[Nephrotic syndrome]] | ||
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| Antiphospholipid syndrome (APLS) or lupus anticoagulant | | [[Antiphospholipid syndrome]] (APLS) or [[lupus anticoagulant]] | ||
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|- | |- | ||
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| Heparin induced thrombocytopenia (HIT) | | [[Heparin-induced thrombocytopenia]] (HIT) | ||
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| Disseminated intravascular coagulopathy (DIC) | | [[Disseminated intravascular coagulopathy]] (DIC) | ||
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|- | |- | ||
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| Paroxysmal nocturnal hemoglobinuria (PNH) | | [[Paroxysmal nocturnal hemoglobinuria]] (PNH) | ||
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|- | |- | ||
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| Autoimmune disorders (Vasculitis, | | Autoimmune disorders ([[Vasculitis]], [[Celiac disease]], [[Inflammatory bowel disease]]) | ||
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| Thrombotic microangiopathy | | [[Thrombotic microangiopathy]] | ||
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| Sickle cell disease | | [[Sickle cell disease]] | ||
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| 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) | | 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) | ||
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==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Hematology]] | [[Category:Hematology]] | ||
Revision as of 15:27, 19 July 2016
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Risk calculators and risk factors for Thrombophilia classification |
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
- 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.
| Thrombophilic states associated with arterial clots |
|---|
| APLS and lupus anticoagulant |
| HIT |
| DIC |
| PNH |
| Cold agglutinins (associated with mycoplasma infections) |
| Vasculitis |
| Hyperhomocysteinemia |
References
- ↑ 1.0 1.1 Hoffman R, Benz EJ, Shattil SJ, et al. Hematology: Basic Principles and Practice: Elsevier Science Health Science Division; 2004.
- ↑ 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.