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- The Factor V Leiden mutation is the most common variant associated with inherited thrombosis.1
- The Factor V Leiden mutation is supported by a high prevalence in the general population (4-6% of US population), and
accounts for 85-95% of activated protein C resistant cases. 1
- Presence of the Factor V Leiden variant enhances the risk of venous thrombosis, with odds ratios (ORs) of 3 to 8 in heterozygotes and 30 to 140 in homozygotes.2
- The Factor II (prothrombin) variant gene is the second most common genetic defect for inherited thrombosis.
- "The increased risk of venous thrombosis in patients who are heterzygous for the prothrombin (G20210A) gene
polymorphism is 3-fold."3
- "Homozygotes for this polymorphism have been described but are very uncommon."3
- Patients with a previous, or current, thrombotic event that have the prothrombin (G20210A) gene polymorphism are
potentially at increased risk for recurrence.
- “Patients with the prothrombin (G20210A) mutation are at increased risk of thrombosis when exposed to other risk factors such as:
- (1) Smoking
- (2) Pregnancy
- (3) Obesity
- (4) Oral Contraceptives
- (5) Immobility1
- "The risk of thrombosis is substantially increased for patients with multiple genetic risk factors (i.e. , the "double hit hypothesis") including the prothrombin (G20210A) gene mutation, Factor V Leiden Leiden mutation, hyperhomocysteinemia, methylenetetrahydrofolate reductase (MTHFR) thermolabile polymorphism, protein C deficiency, protein S deficiency, and antiphospholipid antibody Syndrome(s)."1
- Definition and confirmation of the prothrombin (G20210A) gene polymorphism is necessary for genetic counseling of
patients and family members.1
References
1. Grody W, Griffin J, Taylor A, Korf B, Heit, J. (2001) American College of Medical Genetics Consensus Statement on Factor V Leiden Leiden Mutation Testing, Genetics in Medicine, 3:2, 139-147.
2. Salomon, O., et.al., Single and Combined Prothrombotic Factors in Patients With Idiopathic Venous Thromboembolism, Arterioscler Thromb Vasc Biol. 1999;19:511-518.
3. http://pathology.mc.duke.edu/coag/PTGlflyer2.html |