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Laboratory testing for hypercoagulable disorders
1Hematology/Oncology Service, Walter Reed Army Medical Center, Washington, DC, USA.
Current Opinion in Hematology
|September 1, 1996
Summary
Testing for inherited hypercoagulability in venous thromboembolism patients involves assessing protein S, protein C, and antithrombin III levels. These cost-effective tests aid patient management and family care in high-risk situations.
Area of Science:
- Hematology
- Genetics
- Clinical Medicine
Background:
- Inherited hypercoagulability contributes to venous thromboembolism (VTE).
- Evaluation includes testing for protein S, protein C, antithrombin III, and activated protein C resistance.
- Acquired disorders like antiphospholipid syndrome also cause thrombosis.
Purpose of the Study:
- To outline the diagnostic approach for inherited and acquired hypercoagulable states in VTE patients.
- To highlight the clinical relevance and cost-effectiveness of thrombophilia testing.
Main Methods:
- Functional assays for protein S, protein C, and antithrombin III.
- Plasma-based and DNA-based assays for activated protein C resistance.
- Clinical assessment for risk factors (e.g., oral contraceptives, trauma).
Main Results:
- Inherited and acquired thrombophilia are often seen in younger VTE patients with additional risk factors.
- Testing identifies specific deficiencies or resistance linked to thrombosis.
- Diagnostic tests are commercially available.
Conclusions:
- Thrombophilia testing is valuable for guiding patient management.
- Results can inform risk assessment and care for family members.
- Testing is cost-effective when it influences clinical decisions.