new_n_lost
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DVT in a 40 year old woman. Which is the most likely cause?
Factor V Leiden
Protein C deficiency
Protein S deficiency
Antithrombin III deficiency
Lupus anticoagulant
Edited by new_n_lost on 03/16/07 - 07:56 PM
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| epica
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Protein S
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| epica
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Ans is A
Factor v is most common, Protein S/C less
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| epica
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Pt. got trombotic occlusion of microvascular after Warfarine .
Deficiency?
# Factor V Leiden
# Protein C deficiency
# Protein S deficiency
# Antithrombin III deficiency
# Lupus anticoagulant
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| new_n_lost
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Protein S deficiency ??
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| new_n_lost
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The correct Answer is A
Factor V Leiden is the most common hereditary blood coagualtion disorder in the United States. It is present in 5% of the Caucasian population and 1.2% of the African American population.
Factor V Leiden increases the risk of venous thrombosis 3-8 fold for heterozygous (one damaged gene inherited) and substantially more, 30-140 fold, for homozygous (two damaged genes inherited) individuals.
The prothrombin mutation is the second most common inherited clotting abnormality. It is more common than protein S and C deficiency and Antithrombin deficiency combined; 2% of the general population is heterozygous. It is only a mild risk factor for clots, but together with other risk factors (such as oral contraceptives, surgery, trauma, high blood pressure, obesity, smoking, etc) or combined with other clotting disorders (like Factor V Leiden), the risk of clotting increases dramatically.
Factor V Leiden can be associated with the following complications:
- Venous Thrombosis blood clots in veins, such as:
- Deep vein thrombosis (DVT), veins in arms and legs
- Superficial thrombophlebitis
- Sinus vein thrombosis, veins around the brain
- Mesenteric vein thrombosis, intestinal veins
- Budd-Chiari syndrome, liver veins
- Pulmonary Embolism (PE), blood clots in the lungs
- Arterial clots (stroke, heart attack) in selected patients (some smokers)
- Possibly with stillbirth or recurrent unexplained miscarriage
- Preeclampsia and/or eclampsia (toxemia while pregnant)
Edited by new_n_lost on 03/16/07 - 09:56 PM
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| epica
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Ans is Prot C/S
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| new_n_lost
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Continuing the Discussion on Protein S :-
- Acquired protein S deficiency
- Rarely, an acquired disorder causes protein S deficiency. Acquired deficiencies of protein S occur with liver disease, vitamin K deficiency, or as a result of antagonism with oral warfarin anticoagulants.
- Protein S levels decrease in pregnancy and can fall into the abnormal-low laboratory range. These low levels of protein S in pregnancy do not cause thrombosis by themselves.
- Another seldom recognized cause for acquired protein S deficiency is sickle cell anemia; however, this condition alone does not produce a thrombophilic state.
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| epica
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Protein C is the ans. Can u explain?
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| new_n_lost
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Well Thromotic Occlusion Occurs in Both Protein C n S but in Protein S its more of a pronounced Venous Thrombosis i.e DVT while protein C will have a more dominant microvasculature effect.
Furthermore, Warfarin-induced skin necrosis occurs in the feet, buttocks, thighs, breasts, upper extremities, and genitalia. The lesions usually begin as maculopapular lesions several days after initiation of warfarin and progress into bullous, hemorrhagic, necrotic lesions. Patients with protein C deficiency are at high risk for warfarin-induced skin necrosis during initiation of therapy with warfarin. Approximately one third of patients with warfarin-induced skin necrosis have protein C deficiency.
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| new_n_lost
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So i guess when ever we see a Warfarin induced microvasculature thrombosis we shud have Protien C def. in the Differential Dx
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| shwe
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You means, if Q say warferin, or A. fib, or ?stent in angioplasty or ?prosthetic valve ..
ans sh b prt C defi.Apart fr. warferin ...Any asso. with ASA, plavis.
but with out any above sh b V Leiden.
What is the catch to answer as V Leiden?
Thanks for detail, expl re V Leiden & warferin. relat to this DVT.
NnL pl pm me where can I read re; the expl you had post, where it is from?
Thanks
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| epica
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PERFECT, ( now we will remember this differ)
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| new_n_lost
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The Factor V Leiden is the Answer to the First Question Posted by me the DVT one. The next question posted by Epica was abt Warfarin n its effect on non-platelet causes of Thrombosis i.e the Factor C n Factor S deficiencies
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| new_n_lost
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Here is the Complete Discussion in One Order:-
DVT in a 40 year old woman. Which is the most likely cause?
Factor V Leiden
Protein C deficiency
Protein S deficiency
Antithrombin III deficiency
Lupus anticoagulant
Factor V Leiden is the most common hereditary blood coagualtion disorder in the United States. It is present in 5% of the Caucasian population and 1.2% of the African American population.
Factor V Leiden increases the risk of venous thrombosis 3-8 fold for heterozygous (one damaged gene inherited) and substantially more, 30-140 fold, for homozygous (two damaged genes inherited) individuals.
The prothrombin mutation is the second most common inherited clotting abnormality. It is more common than protein S and C deficiency and Antithrombin deficiency combined; 2% of the general population is heterozygous. It is only a mild risk factor for clots, but together with other risk factors (such as oral contraceptives, surgery, trauma, high blood pressure, obesity, smoking, etc) or combined with other clotting disorders (like Factor V Leiden), the risk of clotting increases dramatically.
Factor V Leiden can be associated with the following complications:
- Venous Thrombosis blood clots in veins, such as:
- Deep vein thrombosis (DVT), veins in arms and legs
- Superficial thrombophlebitis
- Sinus vein thrombosis, veins around the brain
- Mesenteric vein thrombosis, intestinal veins
- Budd-Chiari syndrome, liver veins
- Pulmonary Embolism (PE), blood clots in the lungs
- Arterial clots (stroke, heart attack) in selected patients (some smokers)
- Possibly with stillbirth or recurrent unexplained miscarriage
- Preeclampsia and/or eclampsia (toxemia while pregnant)
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| new_n_lost
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Pt. got trombotic occlusion of microvascular after Warfarine .
Deficiency?
# Factor V Leiden
# Protein C deficiency
# Protein S deficiency
# Antithrombin III deficiency
# Lupus anticoagulant
Well Thromotic Occlusion Occurs in Both Protein C n S but in Protein S its more of a pronounced Venous Thrombosis i.e DVT while protein C will have a more dominant microvasculature effect.
Furthermore, Warfarin-induced skin necrosis occurs in the feet, buttocks, thighs, breasts, upper extremities, and genitalia. The lesions usually begin as maculopapular lesions several days after initiation of warfarin and progress into bullous, hemorrhagic, necrotic lesions. Patients with protein C deficiency are at high risk for warfarin-induced skin necrosis during initiation of therapy with warfarin. Approximately one third of patients with warfarin-induced skin necrosis have protein C deficiency.
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| new_n_lost
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I hope it sorts any confusion as to wht ans is for which question.
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| shwe
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Thanks,
I just try to remember in short cut way, but a bit dangerous & confosion.
So it sh b
DVT, PE.... V leiden.
Skin necrosis/ warferin... prt C defi.
Got it NnL, thanks.
If warferin.... sh b ...prt S defi is the ans, not C defi, correct if wrong pl, thanks
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| epica
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Oh, sorry it's because of my Q, just wanted to mention some points, Sorry.
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