Posts Tagged ‘Thrombophilia’
Stephan Moll, MD writes… An information article on various aspects of thrombophilia, written for patients and family members, was published today – available here – as a Vascular Disease Patient Information Page in the journal Vascular Medicine. It addresses (a) in which patient with venous thromboembolism to consider thrombophilia testing, (b) what tests might be appropriate to do, (c) how the test results might influence length of anticoagulation therapy (d), what contraceptives are safe to use in women with a history of DVT or PE or thrombophilia, and (e) in which family members to consider thrombophilia testing. This article can be used as an education handout for patients in clinic or the hospital who have DVT, PE, venous thrombosis in unusual locations, or an established thrombophilia.
Last updated: April 1st, 2015
Stephan Moll, MD writes… The decision how long to treat a patient with venous thromboembolism (VTE) with anticoagulants can often be made based on the patient’s history alone, i.e. the circumstances of the VTE event (provoked versus unprovoked). Often, no thrombophilia testing is needed. However, if one were to do thrombophilia testing, what is the right time to test? Read the rest of this entry »
Stephan Moll, MD writes…
Ischemic colitis is an uncommon and typically benign disorder. For mostly unclear reasons, multiple small vessels in the colonic wall have decreased perfusion or become occluded, resulting in patchy, superficially ulcerated areas. Typically, no surgical intervention is needed and the patient recovers spontaneously within 1-2 weeks. Often patients have only one episode. Few people have recurrences. Read the rest of this entry »
A patient may ask: “I am on warfarin – can I donate blood?” Your answer: “No”. A person on an anticoagulant will not be accepted as a blood donor Read the rest of this entry »
A new guideline about the prevention, diagnosis, and treatment of DVT and PE associated with pregnancy was published today by ACOG (American College of Obstetricians and Gynecologists) in its respected series of Practice Bulletins. The bulletin includes detailed reference to thromboprophylaxis in pregnant women with thrombophilia. Read the rest of this entry »
How common is pregnancy loss? What are the causes?
Pregnancy loss in the general population is common. Most losses occur in the first trimester. As many as 5 % of women have 2 or more early losses; 1-2 % have 3 or more early losses [ref 1]. Well established risk factors for pregnancy loss are: (a) advanced maternal age, (b) anatomic uterine abnormalities (fibroids, septum, etc), (c) chromosome abnormalities of fetus, mother or father, (d) comorbid diseases of the mother (endocrine, immunologic). The acquired antiphospholipid antibody syndrome is also a risk factor for pregnancy loss. The role of inherited thrombophilias contributing to pregnancy loss is less clear. Read the rest of this entry »
If a thrombophilia (clotting disorder) has been identified in a patient with blood clots (venous thromboembolism = VTE), the question arises whether other family members should be tested for the same thrombophilia.
My Clinical Approach
The 2 main causes of arterial thromboembolism are certainly arteriosclerosis and atrial fibriallation. Only uncommonly do arterial clots occur in persons less than 40 or 50 years of age who do not have arteriosclerosis or atrial fibrillation. Under these circumstances, a number of uncommon conditions, including thrombophilias, should be considered and investigated (see table 1: Causes and work-up). Read the rest of this entry »