Thrombophilia - Thought Process

Congenital vs Inherited

• Congenital
• Type II most common and least serious
• Factor V Leiden - Mutation in Factor V so it can't be degraded by Protein C
• Prothrombin G20210A (2-3x) - high levels of prothrombin due to pre-mRNA stability
• Type I less common and more serious
• Protein S and C deficiency (5-10x)
• Antithrombin III deficiency (BTW heparin increases activity of antithrombin 3000x)
• Acquired
• Antiphospholipid syndrome - abs vs cell membrane phospholipids (lupus anticoagulant, anticardiolipin antibodies, anti-B2glycoprotein 1 antibodies)
• HIT
• Nephrotic syndrome, pregnancy, estrogen