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Thrombophilias: Guide to Hereditary and Acquired Conditions

Thrombophilias may be hereditary or acquired and the risk/severity of thrombosis varies widely between conditions.

Hereditary ThrombophiliaRelative Risk For A First Venous Thromboembolism (Compared To Community Controls)
Factor V Leiden

  • Heterozygous
  • Homozygous
3x – 7x
80x
Prothrombin G20210A

  • Heterozygous
  • Homozygous
2x – 3x

5x

Double heterozygosity (Factor V Leiden and prothrombin G20210A)6x
Antithrombin deficiency5x
Protein C deficiency4x – 6.5x
Protein S deficiency1x – 3x
Pseudohomozygous Factor V Leiden80x
Factor IX Padua10x
Antithrombin resistance2x – 3x
Factor VIII ≥150 IU/dl3x – 5x
Factor IX ≥129 IU/dl2.3x
Factor XI ≥121 IU/dl2x

Adapted from: Campello E, Spiezia L, Adamo A, Simioni P. Thrombophilia, risk factors and prevention. Expert Rev Hematol. 2019 Mar 4;12(3):147–58.

Acquired ThrombophiliaRelative Risk For A First Venous Thromboembolism (Compared To Community Controls)
Antiphospholipid antibody syndrome3x – 10x
Hyperhomocysteinemia1.5x – 3x
Surgery1.7x – 2.8x
Trauma3x – 5x
Pregnancy5x – 50x
Estrogen-progestogen therapies2x – 9x
Cancer4x – 7x
Myeloproliferative neoplasms3x
Economy class syndrome (DVT on long haul flights)2x – 4x
Obesity (BMI ≥30 Kg/m2)2x – 3x

Adapted from: Campello E, Spiezia L, Adamo A, Simioni P. Thrombophilia, risk factors and prevention. Expert Rev Hematol. 2019 Mar 4;12(3):147–58.

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