Thrombosis Panel (Test Code 4820) Please Complete All Pages of the Mammalian Plasma

Total Page:16

File Type:pdf, Size:1020Kb

Thrombosis Panel (Test Code 4820) Please Complete All Pages of the Mammalian Plasma Shipping requirements References Ship on an ice pack or at room Alhenc-Gelas M, Plu-Bureau G, Hugon-Rodin J, Picard V, Horellou MH; GFHT study temperature. Protect from freezing. group on Genetic Thrombophilia. 2017. Thrombotic risk according to SERPINC1 genotype in a large cohort of subjects with antithrombin inherited deficiency. Place the specimen and the requisition Thrombosis Thromb Haemost. Mar 16. doi: 10.1160/TH16-08-0635. into plastic bags and seal. Insert into Desch KC. 2015. Dissecting the Genetic Determinants of Hemostasis and a Styrofoam container, seal and place Thrombosis Curr Opin Hematol. September; 22(5):428–436. into a sturdy cardboard box, and De Stefano V, Rossi E. 2013. Testing for inherited thrombophilia and consequences tape securely. Ship the package in for antithrombotic prophylaxis in patients with venous thromboembolism and Panel ORDER SHIP compliance with your overnight carrier their relatives. A review of the Guidelines from Scientific Societies and Working guidelines. Label with the following Groups. Thromb Haemost. Oct;110(4):697-705. address: Fukushima N, Itamura H et al. 2014. A Novel Frameshift Mutation in Exon 4 Causing Client Services/Diagnostic Laboratory a Deficiency of High-molecular-weight Kininogen in a Patient with Splenic Infarction. Intern Med 53: 253-257. BloodCenter of Wisconsin 638 N. 18th St. Martinelli I, De Stefano V, Mannucci PM. 2014. Inherited risk factors for venous thromboembolism. Nat Rev Cardiol. Mar;11(3):140-56. Milwaukee, WI 53233 Mukai S, Nagata K et al. 2016. Genetic analyses of novel compound heterozygous hypodysfibrinogenemia, Tsukuba I: FGG c.1129+62_65 del AATA and FGG c.1299+4 del A. Thromb Res. Dec;148:111-117. BloodCenter of Wisconsin offers a specifically This panel evaluates for single nucleotide variants and small Required forms deletions and duplications, which are most commonly Poon IKH, Patel KK et al. 2011. Histidine-rich glycoprotein: the Swiss Army knife of designed Thrombosis Panel (test code 4820) Please complete all pages of the mammalian plasma. Blood.117:2093-2101. responsible for genetic disease. However, large deletions and optimized for detection of germline variants duplications, also referred to as copy number variants (CNV), are requisition form. Clinical history Rehm HL, Bale SJ et al. 2013. Working Group of the American College of Medical (including patient’s ethnicity, clinical Genetics and Genomics Laboratory Quality Assurance Committee. ACMG clinical in 12 genes known to be associated with a known cause of genetic disorders, but can escape detection diagnosis, family history and relevant laboratory standards for next-generation sequencing. Genet Med.15:733-747. an increased risk for developing venous by next-generation sequence analysis. Further testing with the BloodCenter of Wisconsin custom designed, high-density laboratory findings) is necessary for Richards S, Aziz N A et al. 2015. Standards and guidelines for the interpretation of thromboembolism. optimal interpretation of genetic test sequence variants: a joint consensus recommendation of the American College gene-focused array, aCGH Deletion/Duplication Analysis, allows of Medical Genetics and Genomics and the Association for Molecular Pathology. ORDER results and recommendations. ClinicalSHIP for the possible detection of large deletions and duplications Genet Med.17:405-424. within a single exon of a given gene, encompassing one or more and laboratory history can either be Venous thromboembolism (VTE), including deep vein thrombosis Tang L, Wang HF et al. 2013. Common Genetic Risk Factors for Venous Thrombosis exons, or affecting an entire gene. This testing may be warranted recorded on the requisition form or (DVT) and pulmonary embolism (PE) is a common, yet complex in the Chinese Population. Am J Hum Genet. Feb 7; 92(2): 177–187. when results of sequence analysis do not fully explain a clinical clinical and laboratory reports can be disorder. Inherited risk factors involved in the pathogenesis of Stevens SM, Woller SC et al. 2016. Guidance for the evaluation and treatment of phenotype, or when a suspected disorder is known to be caused submitted with the sample. this disorder include inherited thrombophilias that are caused hereditary and acquired thrombophilia. J Thromb Thromolysis. 41:154-164. by deletions or duplications. Please refer to the aCGH Deletion/ by loss-of-function of anticoagulant proteins, gain-of-function Trégouët DA, Delluc A, et al. 2016. Is there still room for additional common Duplication Analysis test description for more information about susceptibility alleles for venous thromboembolism? J Thromb Haemost. of procoagulants or defects in the fibrinolytic pathways. These specific genes included in this array. CPT Codes/Billing/Turnaround time Sep;14(9):1798-802. inherited risk factors, together with acquired risk factors, Test Code: 4820 Zhao L, Liu B, Li C. 2015. Progress in research into the genes associated with venous predispose an individual to thrombosis. Not all individuals Refer to the table inside for further information about each thromboembolism. World J Emerg Med. 6(2):100–104. with a genetic predisposition to thrombosis will develop gene, clinical phenotype, OMIM number and inheritance CPT codes: 81479 VTE; the relative risk for thrombosis may be influenced by the pattern. Turnaround time: 21 days specific variant present, whether the variant(s) is heterozygous, The CPT codes provided are subject to change as more compound heterozygous or homozygous, the concomitance information becomes available. CPT codes are provided only as of other pathogenic variants, a family history of DVT, as well guidance to assist clients with billing. as the presence of other inherited, and/or acquired risk factors. Identifying individuals who have an increased genetic For additional information related to shipping, billing or pricing, susceptibility for VTE may assist providers in developing an please contact, BloodCenter Client Services: (414) 937-6396 or individualized risk assessment which in some cases may guide 800-245-3117, Option 1, or [email protected]. management decisions, assist with the identification of affected family members and allow for accurate genetic recurrence risk assessment. In addition, the identification of women who have one or more inherited thrombophilia variants may provide important information for contraception and pregnancy management. This panel includes Factor V Leiden and prothrombin 20210G>A variants, genes associated with coagulation factor regulatory proteins (ADAMTS13, protein C, protein S, and antithrombin), as well as other genes that are associated with an increased risk for thrombosis. Disorders in this panel may be inherited in an autosomal dominant and/or autosomal recessive manner. © Copyright 2017 r0818 BloodCenter of Wisconsin, Inc. , Part of Versiti. All rights reserved. Thrombosis Panel: gene, clinical phenotype, OMIM number and inheritance pattern. Indications for testing Assay sensitivity and limitations Gene Clinical Phenotype Phenotype/Gene Inheritance Thrombosis Panel: The analytical sensitivity of this test is >99% for single nucleotide OMIM number • Clarification and/or confirmation of diagnosis in a patient with changes and insertions and deletions of less than 20 bp. This ADAMTS13 Upshaw-Schulman syndrome: congenital thrombotic thrombocytopenic purpura (TTP), a 274150/604134 Autosomal Recessive clinical findings of thromboembolism which may be related to assay does not detect large deletions or duplications (>20 bp) life-threatening condition characterized by consumption of platelets, hemolytic anemia, one or more genes or deletions, duplications or variants that are outside the regions and varying degrees of organ dysfunction that presents in childhood, or in adults with sequenced. To order analysis of copy number variation at the presentation often triggered by stress events, such as pregnancy. • Identification of individuals at increased susceptibility for exon or gene level, please refer to the aCGH Deletion/Duplication F2 Prothrombin 20210G>A variant only: the relative risk for venous thromboembolism in 188050/176930 Autosomal Dominant thrombosis due to a family history of an unspecified thrombosis Analysis test, if available, or contact Client Services before placing heterozygotes is increased two-to-fivefold and may be higher in the presence of other disorder to provide thrombotic risk assessment which may your order. factors. Homozygotes are expected to have an increased relative risk over heterozygotes. assist with treatment and management, reproductive risk F5 Factor V Leiden variant only: the most common inherited form of thrombophilia 188055/612309 Autosomal Dominant assessment and genetic counseling Reporting of results due to activated protein C (APC) resistance. The risk for venous thromboembolism is Single gene sequencing or custom gene panel: While this assay is designed to detect germline genetic variants increased three-to-eightfold in factor V Leiden heterozygotes and ten-to-eightyfold in associated with thrombosis risk, variants unrelated to the homozygotes. • Analysis of genes included in the Thrombosis Panel may also indication for testing, but with other clinical and/or reproductive be ordered as a stand-alone single gene sequencing test or FGA Pathogenic variants in FGA, FGB and FGG result in quantitative and/or qualitative 202400/134820 Autosomal Recessive implications, may also be detected. A comprehensive database of changes in the fibrinogen alpha, beta or gamma
Recommended publications
  • The Rare Coagulation Disorders
    Treatment OF HEMOPHILIA April 2006 · No. 39 THE RARE COAGULATION DISORDERS Paula HB Bolton-Maggs Department of Haematology Manchester Royal Infirmary Manchester, United Kingdom Published by the World Federation of Hemophilia (WFH) © World Federation of Hemophilia, 2006 The WFH encourages redistribution of its publications for educational purposes by not-for-profit hemophilia organizations. In order to obtain permission to reprint, redistribute, or translate this publication, please contact the Communications Department at the address below. This publication is accessible from the World Federation of Hemophilia’s web site at www.wfh.org. Additional copies are also available from the WFH at: World Federation of Hemophilia 1425 René Lévesque Boulevard West, Suite 1010 Montréal, Québec H3G 1T7 CANADA Tel. : (514) 875-7944 Fax : (514) 875-8916 E-mail: [email protected] Internet: www.wfh.org The Treatment of Hemophilia series is intended to provide general information on the treatment and management of hemophilia. The World Federation of Hemophilia does not engage in the practice of medicine and under no circumstances recommends particular treatment for specific individuals. Dose schedules and other treatment regimes are continually revised and new side effects recognized. WFH makes no representation, express or implied, that drug doses or other treatment recommendations in this publication are correct. For these reasons it is strongly recommended that individuals seek the advice of a medical adviser and/or to consult printed instructions provided by the pharmaceutical company before administering any of the drugs referred to in this monograph. Statements and opinions expressed here do not necessarily represent the opinions, policies, or recommendations of the World Federation of Hemophilia, its Executive Committee, or its staff.
    [Show full text]
  • I, Paul Knoebl
    Knoebl 2020-12-09 Public Declaration of Interests and Confidentiality Undertaking of European Medicines Agency (EMA), Scientific Committee members and experts Public declaration of interests I, Paul Knoebl Organisation/Company: Medical University of Vienna Country: Austria do hereby declare on my honour that, to the best of my knowledge, the only direct or indirect interests I have in the pharmaceutical industry are those listed below: 2.1 Employment No interest declared 2.2 Consultancy Period Company Products Therapeutic Indication 01/2009-(current) Novo Nordisk acquired hemophilia, congenital hemophilia, rare bleeding disorders 01/2012-02/2019 Baxalta (now Shire) thrombotic thrombocytopenic purpura purpura fulminans acquired hemophilia 01/2012-01/2016 Alexion thrombotic microangiopathy 03/2010-07/2018 Ablynx thrombotic microangiopathy 07/2018-(current) Sanofi Genzyme thrombotic microangiopathy 02/2019-(current) Takeda thrombotic microangiopathy Acquired hemophilia 2.3 Strategic advisory role No interest declared 2.4 Financial interests Classified as public by the European Medicines Agency DOI Form Version-number: 4 Knoebl 2020-12-09 2 No interest declared 2.5 Principal investigator Period Company Products Therapeutic Indication 01/2013-(current) Baxalta, then Shire, now Takeda BAX930 Upshaw Schulman Syndrome 01/2013-(current) Novo Nordisc Concizumab Hemophilia 09/2010-04/2014 Gilead Ambisome fungal infections 09/2010-04/2014 MSD Posaconazol fungal infections 03/2010-(current) Ablynx caplacizumab thrombotic thrombocytopenic purpura 04/2010-01/2012
    [Show full text]
  • The Approach to Thrombosis Prevention Across the Spectrum of Philadelphia-Negative Classic Myeloproliferative Neoplasms
    Review The Approach to Thrombosis Prevention across the Spectrum of Philadelphia-Negative Classic Myeloproliferative Neoplasms Steffen Koschmieder Department of Medicine (Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation), Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, D-52074 Aachen, Germany; [email protected]; Tel.: +49-241-8080981; Fax: +49-241-8082449 Abstract: Patients with myeloproliferative neoplasm (MPN) are potentially facing diminished life expectancy and decreased quality of life, due to thromboembolic and hemorrhagic complications, progression to myelofibrosis or acute leukemia with ensuing signs of hematopoietic insufficiency, and disturbing symptoms such as pruritus, night sweats, and bone pain. In patients with essential thrombocythemia (ET) or polycythemia vera (PV), current guidelines recommend both primary and secondary measures to prevent thrombosis. These include acetylsalicylic acid (ASA) for patients with intermediate- or high-risk ET and all patients with PV, unless they have contraindications for ASA use, and phlebotomy for all PV patients. A target hematocrit level below 45% is demonstrated to be associated with decreased cardiovascular events in PV. In addition, cytoreductive therapy is shown to reduce the rate of thrombotic complications in high-risk ET and high-risk PV patients. In patients with prefibrotic primary myelofibrosis (pre-PMF), similar measures are recommended as in those with ET. Patients with overt PMF may be at increased risk of bleeding and thus require a more individualized approach to thrombosis prevention. This review summarizes the thrombotic Citation: Koschmieder, S. The risk factors and primary and secondary preventive measures against thrombosis in MPN. Approach to Thrombosis Prevention across the Spectrum of Keywords: myeloproliferative neoplasms (MPN); polycythemia vera (PV); essential thrombocythemia Philadelphia-Negative Classic (ET); primary myelofibrosis (PMF); thrombosis; prevention; antiplatelet agents; anticoagulation; cy- Myeloproliferative Neoplasms.
    [Show full text]
  • What Is Dvt? Deep Vein Thrombosis (DVT) Occurs When an Abnormal Blood Clot Forms in a Large Vein
    What is DVt? Deep vein thrombosis (DVT) occurs when an abnormal blood clot forms in a large vein. These clots usually develop in the lower leg, thigh, or pelvis, but can also occur in other large veins in the body. If you develop DVT and it is diagnosed correctly and quickly, it can be treated. However, many people do not know if they are at risk, don’t know the symptoms, and delay seeing a healthcare professional if they do have symptoms. CAn DVt hAppen to me? Anyone may be at risk for DVT but the more risk factors you have, the greater your chances are of developing DVT. Knowing your risk factors can help you prevent DVt: n Hospitalization for a medical illness n Recent major surgery or injury n Personal history of a clotting disorder or previous DVT n Increasing age this is serious n Cancer and cancer treatments n Pregnancy and the first 6 weeks after delivery n Hormone replacement therapy or birth control products n Family history of DVT n Extended bed rest n Obesity n Smoking n Prolonged sitting when traveling (longer than 6 to 8 hours) DVt symptoms AnD signs: the following are the most common and usually occur in the affected limb: n Recent swelling of the limb n Unexplained pain or tenderness n Skin that may be warm to the touch n Redness of the skin Since the symptoms of DVT can be similar to other conditions, like a pulled muscle, this often leads to a delay in diagnosis. Some people with DVT may have no symptoms at all.
    [Show full text]
  • A 12-Years Rectal Bleeding Complicated with Deep Vein Thrombosis, Is Hemorrhoid the Real Cause?
    Case Report Clinical Case Reports Volume 10:11, 2020 DOI: 10.37421/jccr.2020.10.1395 ISSN: 2165-7920 Open Access A 12-Years Rectal Bleeding Complicated with Deep Vein Thrombosis, Is Hemorrhoid the Real Cause? Yi-Qun Zhang, Meng Niu and Chun-Xiao Chen* Department of Gastroenterology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, P. R. China Abstract Colorectal venous malformation is a rare condition that can cause massive rectal bleeding. This is the first report of colorectal venous malformation complicated with massive bleeding and lowers limb deep vein thrombosis, and the two life-threatening conditions were both treated successfully. Keywords: Colorectal venous malformation • Rectal bleeding • Sclerotherapy • Deep vein thrombosis Introduction A 16-year-old man presented to the clinic with long-standing recurrent hematochezia and profound anemia. Per the mother, his rectal bleeding was first noticed around the age of 4 with one episode per 2-3 months that was diagnosed as hemorrhoids without specific treatment. It had worsened for 2 months with progression to 1 bloody bowel movement daily. He had no family history of hematologic disorders or vascular anomalies. The patient had accepted 600 ml red-blood cell perfusion and intravenous sucrose-iron transfusions for severe anemia with hemoglobin 5.8 g/dL, hematocrit 25.9% and MCV 69.7 fL at local hospital. Case Report Upon admission, the patient’s vital signs were within normal limits. His abdomen was supple and without tenderness. Digital rectal examination confirmed partially thrombosed, circumferential mixed hemorrhoids. Laboratory tests revealed a hemoglobin 8.0 g/L and D-dimer 15760 g/L.
    [Show full text]
  • ISTH Couverture 6.6.2012 10:21 Page 1 ISTH Couverture 6.6.2012 10:21 Page 2 ISTH Couverture 6.6.2012 10:21 Page 3 ISTH Couverture 6.6.2012 10:21 Page 4
    ISTH Couverture 6.6.2012 10:21 Page 1 ISTH Couverture 6.6.2012 10:21 Page 2 ISTH Couverture 6.6.2012 10:21 Page 3 ISTH Couverture 6.6.2012 10:21 Page 4 ISTH 2012 11.6.2012 14:46 Page 1 Table of Contents 3 Welcome Message from the Meeting President 3 Welcome Message from ISTH Council Chairman 4 Welcome Message from SSC Chairman 5 Committees 7 ISTH Future Meetings Calendar 8 Meeting Sponsors 9 Awards and Grants 2012 12 General Information 20 Programme at a Glance 21 Day by Day Scientific Schedule & Programme 22 Detailed Programme Tuesday, 26 June 2012 25 Detailed Programme Wednesday, 27 June 2012 33 Detailed Programme Thursday, 28 June 2012 44 Detailed Programme Friday, 29 June 2012 56 Detailed Programme Saturday, 30 June 2012 68 Hot Topics Schedule 71 ePoster Sessions 97 Sponsor & Exhibitor Profiles 110 Exhibition Floor Plan 111 Congress Centre Floor Plan www.isth.org ISTH 2012 11.6.2012 14:46 Page 2 ISTH 2012 11.6.2012 14:46 Page 3 WelcomeCommittees Messages Message from the ISTH SSC 2012 Message from the ISTH Meeting President Chairman of Council Messages Dear Colleagues and Friends, Dear Colleagues and Friends, We warmly welcome you to the elcome It is my distinct privilege to welcome W Scientific and Standardization Com- you to Liverpool for our 2012 SSC mittee (SSC) meeting of the Inter- meeting. national Society on Thrombosis and Dr. Cheng-Hock Toh and his col- Haemostasis (ISTH) at Liverpool’s leagues have set up a great Pro- UNESCO World Heritage Centre waterfront! gramme aiming at making our off-congress year As setting standards is fundamental to all quality meeting especially attractive for our participants.
    [Show full text]
  • Whole-Exome Sequencing of a Patient with Severe and Complex Hemostatic Abnormalities Reveals a Possible Contributing Frameshift Mutation in C3AR1
    Downloaded from molecularcasestudies.cshlp.org on October 2, 2021 - Published by Cold Spring Harbor Laboratory Press Whole-exome sequencing of a patient with severe and complex hemostatic abnormalities reveals a possible contributing frameshift mutation in C3AR1 Eva Leinøe1, Ove Juul Nielsen1, Lars Jønson2 and Maria Rossing2∗ Department of Hematology1 and Center for Genomic Medicine2, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark Running head: WES reveals a C3AR1 mutation in a complex hemostatic patient ∗Corresponding author: Maria Rossing Center for Genomic Medicine Rigshospitalet University of Copenhagen Blegdamsvej 9 DK-2100 Copenhagen Denmark E-mail: [email protected] Phone: +45 3545 3016 Fax: +45 3545 4435 1 Downloaded from molecularcasestudies.cshlp.org on October 2, 2021 - Published by Cold Spring Harbor Laboratory Press Abstract The increasing availability of genome-wide analysis has made it possible to rapidly sequence the exome of patients with undiagnosed or unresolved medical conditions. Here, we present the case of a 64-year-old male patient with schistocytes in the peripheral blood smear and a complex and life-threatening coagulation disorder causing recurrent venous thromboembolic events, severe thrombocytopenia, and subdural hematomas. Whole-exome sequencing revealed a frameshift mutation (C3AR1 c.355-356dup, p.Asp119Alafs*19) resulting in a premature stop in C3AR1 (Complement Component 3a Receptor 1). Based on this finding, atypical hemolytic uremic syndrome was suspected due to a genetic predisposition, and a targeted treatment regime with Eculizumab was initiated. Life-threatening hemostatic abnormalities would most likely have persisted had it not been for the implementation of whole-exome sequencing in this particular clinical setting.
    [Show full text]
  • Diagnosis of Hemophilia and Other Bleeding Disorders
    Diagnosis of Hemophilia and Other Bleeding Disorders A LABORATORY MANUAL Second Edition Steve Kitchen Angus McCraw Marión Echenagucia Published by the World Federation of Hemophilia (WFH) © World Federation of Hemophilia, 2010 The WFH encourages redistribution of its publications for educational purposes by not-for-profit hemophilia organizations. For permission to reproduce or translate this document, please contact the Communications Department at the address below. This publication is accessible from the World Federation of Hemophilia’s website at www.wfh.org. Additional copies are also available from the WFH at: World Federation of Hemophilia 1425 René Lévesque Boulevard West, Suite 1010 Montréal, Québec H3G 1T7 CANADA Tel.: (514) 875-7944 Fax: (514) 875-8916 E-mail: [email protected] Internet: www.wfh.org Diagnosis of Hemophilia and Other Bleeding Disorders A LABORATORY MANUAL Second Edition (2010) Steve Kitchen Angus McCraw Marión Echenagucia WFH Laboratory WFH Laboratory (co-author, Automation) Training Specialist Training Specialist Banco Municipal Sheffield Haemophilia Katharine Dormandy de Sangre del D.C. and Thrombosis Centre Haemophilia Centre Universidad Central Royal Hallamshire and Thrombosis Unit de Venezuela Hospital The Royal Free Hospital Caracas, Venezuela Sheffield, U.K. London, U.K. on behalf of The WFH Laboratory Sciences Committee Chair (2010): Steve Kitchen, Sheffield, U.K. Deputy Chair: Sukesh Nair, Vellore, India This edition was reviewed by the following, who at the time of writing were members of the World Federation of Hemophilia Laboratory Sciences Committee: Mansoor Ahmed Clarence Lam Norma de Bosch Sukesh Nair Ampaiwan Chuansumrit Alison Street Marión Echenagucia Alok Srivastava Andreas Hillarp Some sections were also reviewed by members of the World Federation of Hemophilia von Willebrand Disease and Rare Bleeding Disorders Committee.
    [Show full text]
  • Thrombosis in the Antiphospholipid Syndrome
    Thrombosis in the antiphospholipid syndrome Reyhan D‹Z KÜÇÜKKAYA Division of Hematology, Department of Internal Medicine, Istanbul University, Istanbul School of Medicine, Istanbul, TURKEY Turk J Hematol 2006;23(1): 5-14 INTRODUCTION her autoimmune disorders, especially with systemic lupus erythematosus (SLE)[8]. Besi- Antiphospholipid antibodies (aPLA) are des these autoimmune conditions, aPLA may heterogenous antibodies directed against be present in healthy individuals, in patients phospholipid–protein complexes. Antiphosp- with hematologic and solid malignancies, in holipid syndrome (APS) is diagnosed when ar- patients with certain infections [syphilis, lep- terial and/or venous thrombosis or recurrent rosy, human immunodeficiency virus (HIV), fetal loss occurs in a patient in whom scre- cytomegalovirus (CMV), Epstein-Barr virus ening for aPLA are positive. Because both (EBV), etc.], and in patients being treated thrombosis and fetal loss are common in the with some drugs (phenothiazines, procaina- population, persistent positivity of aPLA is mide, phenytoin etc.). Those antibodies are important. This syndrome is predominant in defined as “alloimmune aPLA”, and they are females (female to male ratio is 5 to 1), espe- generally transient and not associated with cially during the childbearing years[1-7]. the clinical findings of APS[9]. A minority of As in the other autoimmune disorders, APS patients may acutely present with mul- aPLA and APS may accompany other autoim- tiple simultaneous vascular occlusions affec- mune diseases and certain situations. APS is ting small vessels predominantly, and this is referred to as “primary” when it occurs alone termed as “catastrophic APS (CAPS)”[1-7]. or “secondary” when it is associated with ot- Milestones in the Antiphospholipid Syndrome History Antifosfolipid sendromu The first antiphospholipid antibodies we- Anahtar Kelimeler: Antifosfolipid sendromu, Antifosfolipid re discovered by Wasserman et al.[10] in antikorlar, Tromboz.
    [Show full text]
  • Factor V Leiden Thrombophilia
    Factor V Leiden thrombophilia Description Factor V Leiden thrombophilia is an inherited disorder of blood clotting. Factor V Leiden is the name of a specific gene mutation that results in thrombophilia, which is an increased tendency to form abnormal blood clots that can block blood vessels. People with factor V Leiden thrombophilia have a higher than average risk of developing a type of blood clot called a deep venous thrombosis (DVT). DVTs occur most often in the legs, although they can also occur in other parts of the body, including the brain, eyes, liver, and kidneys. Factor V Leiden thrombophilia also increases the risk that clots will break away from their original site and travel through the bloodstream. These clots can lodge in the lungs, where they are known as pulmonary emboli. Although factor V Leiden thrombophilia increases the risk of blood clots, only about 10 percent of individuals with the factor V Leiden mutation ever develop abnormal clots. The factor V Leiden mutation is associated with a slightly increased risk of pregnancy loss (miscarriage). Women with this mutation are two to three times more likely to have multiple (recurrent) miscarriages or a pregnancy loss during the second or third trimester. Some research suggests that the factor V Leiden mutation may also increase the risk of other complications during pregnancy, including pregnancy-induced high blood pressure (preeclampsia), slow fetal growth, and early separation of the placenta from the uterine wall (placental abruption). However, the association between the factor V Leiden mutation and these complications has not been confirmed. Most women with factor V Leiden thrombophilia have normal pregnancies.
    [Show full text]
  • Extensive Purpura and Necrosis of the Leg
    PHOTO CHALLENGE Extensive Purpura and Necrosis of the Leg Michael Musharbash, MD; Lida Zheng, MD; Lauren Guggina, MD A 57-year-old woman presented with expanding purpura on the left leg of 2 weeks’ duration following a recent hema- topoietic stem cell transplant for refractory diffuse large B-cell lymphoma. Prior to dermatologic consultation, the patient had been hospitalizedcopy for 2 months following the transplant due to Clostridium difficile colitis, Enterococcus faecium bactere- mia, cardiac arrest, delayed engraftment with pancytopenia, and atypical hemolytic uremic syndrome with acute renal failure requiring hemodialysis and treatment with eculizumab. Hernot care team in the hospital initially noticed a small purpuric lesion on the posterior aspect of the left knee. The patient subsequently developed persistent fevers and expansion of the lesion, which prompted consultation of the dermatology ser- vice. Physical examination revealed a 22×10-cm, rectangular, indurated, purpuric plaque with central dusky, violaceous to black necrosis with superficial skin sloughing and peripheral dusky erythema extending from the inner thigh to the lower leg. The left distal leg felt cool, and both dorsalis pedis and posterior tibial pulses were absent. Laboratory test results revealed neutropenia and thrombocytopenia 3 3 Do 3 3 (white blood cell count, 0.2×10 /mm [reference range, 5–10×10 /mm ]; hematocrit, 23.2% [reference range, 41%–50%]; platelet count, 105×103/µL [reference range, 150–350×103/µL]). A punch biopsy was performed. WHAT’S THE DIAGNOSIS? a. disseminated aspergillosis b. disseminated intravascular coagulation c. disseminated mucormycosis d. purpura fulminans e. pyodermaCUTIS gangrenosum PLEASE TURN TO PAGE E2 FOR THE DIAGNOSIS From the Department of Dermatology, Northwestern Memorial Hospital, Chicago, Illinois.
    [Show full text]
  • Factor V Leiden Thrombophilia Jody Lynn Kujovich, MD
    GENETEST REVIEW Genetics in Medicine Factor V Leiden thrombophilia Jody Lynn Kujovich, MD TABLE OF CONTENTS Pathogenic mechanisms and molecular basis.................................................2 Obesity ...........................................................................................................8 Prevalence..............................................................................................................2 Surgery...........................................................................................................8 Diagnosis................................................................................................................2 Thrombosis not convincingly associated with Factor V Leiden....................8 Clinical diagnosis..............................................................................................2 Arterial thrombosis...........................................................................................8 Testing................................................................................................................2 Myocardial infarction.......................................................................................8 Indications for testing......................................................................................3 Stroke .................................................................................................................8 Natural history and clinical manifestations......................................................3 Genotype-phenotype
    [Show full text]