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The contact system.

Craig S Kitchens1

  • 1Division of Hematology/Oncology, Department of Medicine, University of Florida, Gainesville, USA. craig.kitchens@med.va.gov

Archives of Pathology & Laboratory Medicine
|November 8, 2002
PubMed
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Reduced activity of contact factors is linked to various conditions, but not strongly associated with thrombophilia. Routine testing for contact factor activity is not recommended for patients with thromboembolism.

Area of Science:

  • Hematology
  • Thrombosis Research
  • Coagulation Factor Studies

Background:

  • Contact factors (e.g., Factor XII) play a role in hemostasis.
  • Disorders affecting contact factor activity are diverse, including liver disease and antiphospholipid syndrome.
  • Previous research has explored potential links between contact factor activity and thrombophilia.

Purpose of the Study:

  • To review literature on conditions affecting contact factor activity.
  • To assess evidence associating reduced contact factor activity with thrombophilia.
  • To clarify the role of contact factors in thromboembolic events.

Main Methods:

  • Comprehensive literature search of MEDLINE (1988-2001) and relevant references.
  • Extraction of clinical and laboratory data from selected studies.

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  • Qualitative synthesis of evidence due to heterogeneity of reports; meta-analysis not feasible.

    • Main Results:

    • Various disorders are associated with decreased contact factor activity, notably liver disease, neonatal hepatic immaturity, and antiphospholipid syndrome.
    • Evidence for causality between homozygous contact factor deficiency and thrombophilia is unconvincing.
    • Apparent associations in antiphospholipid syndrome are often due to in vitro assay interference, not true reduced activity.

    Conclusions:

    • Current evidence does not support a causal link between reduced contact factor activity and thrombophilia.
    • The antiphospholipid syndrome better explains thrombosis in affected individuals than contact factor levels.
    • Measurement of contact factor activity is not recommended in routine evaluations for thromboembolism or acute coronary syndromes.