Thrombophilia classification

Thrombophilia Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Thrombophilia from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
X Ray
CT
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Thrombophilia classification On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Thrombophilia classification All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Thrombophilia classification
CDC on Thrombophilia classification
Thrombophilia classification in the news
Blogs on Thrombophilia classification
Directions to Hospitals Treating Thrombophilia
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

• Thrombophilias are typically classified into three categories:

1. Inherited or primary hypercoagulable states
2. Acquired or secondary hypercoagulable states
3. Mixed/unknown

• Certain conditions are associated with greater thrombotic risks and both venous and arterial clots.

Classification

• Thrombophilia can be classified into three subtypes.

• 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