A Positive Test for Hypercoagulability
Presence of factor V Leiden (can be heterozygous or homozygous)
Presence of prothrombin 20210 mutation (can be heterozygous or homozygous)
Presence of antiphospholipid antibody; could be manifested as lupus anticoagulant or anticardiolipin antibodies or anti-beta 2 glycoprotein 1 antibodies (IgG, IgM, IgA)
Deficiency of protein C not produced by Coumadin or other acquired cause
Deficiency of protein S not produced by Coumadin or other acquired cause
Deficiency of antithrombin not produced by heparin or low-molecular-weight heparin therapy or other acquired cause
Suggested Additional Lab Testing
Test for activated protein C resistance as a screening test for factor V Leiden mutation.
If screening test suggests a heterozygous or homozygous form of factor V Leiden mutation, perform a genetic test to determine zygosity.
If lupus anticoagulant is present, the activated protein C resistance test will suffer interference; only the genetic test for factor V Leiden should be performed in this circumstance.
Perform genetic test for prothrombin 20210 mutation; there is no simple screening test for this abnormality.
Test for antiphospholipid antibody, both for lupus anticoagulant and anticardiolipin antibodies, and/or anti-beta 2 glycoprotein 1 antibodies (IgG and IgM at least).
Test for protein C functional activity; if the functional activity is low, test for protein C antigen to reveal type of protein C deficiency.
Test for protein S either by functional assay or free antigen assay; if there is a deficiency, measure total protein S antigen to type a congenitally low protein S patientt. Test for antithrombin functional activity; if it is low in absence of heparin, measure antithrombin antigenic activity to type the deficiency.
Copyright © 2017, 2013 Decision Support in Medicine, LLC. All rights reserved.
No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. The Licensed Content is the property of and copyrighted by DSM.