Excess Factor VIII: A Common Cause of Hypercoagulability
http://www.100md.com
《家庭医学美国版》
the Department of Family Medicine, Stony Brook University, Stony Brook, NY
Abstract
Background: Elevations of coagulation factor VIII have recently been described in significant numbers of patients with venous thromboembolism (VTE) previously thought to have had an "idiopathic" event. Three patients from a family practice are presented with recurrent VTE and increased factor VIII levels.
Method: The case histories and results of laboratory tests were reviewed.
Results: The 3 patients had no other clear coagulopathy. In 2 of the 3, the increase was confirmed with a second reading.
Conclusions: Factor VIII assay should be considered in the work-up of idiopathic, recurrent VTE. Long-term anticoagulation may be appropriate in this setting.
References
Locke CF and Evans NC. Evaluating idiopathic venous thromboembolism: what is necessary, what is not. J Fam Pract 2003; 52: 770–6.
Ridker PM, Militich JP, Hennekens CH, Buring JE. Ethnic distribution of factor V Leiden in 4047 men and women. Implications for venous thromboembolism screening. JAMA 1997; 277: 1305–7.
Koster T, Blann AD, Briet E, Vandenbroucke JP, Rosendaal FR. Role of clotting factor VIII in effect of von Willebrand factor on occurrence of deep-vein thrombosis. Lancet 1995; 345: 152–5.
Kraaijenhagen RA, in’t Anker PS, Koopman MM, et al. High plasma concentration of factor VIIIc is a major risk factor for venous thromboembolism. Thromb Haemost 2000; 83: 5–9.
Kyrle PA, Minar E, Hirschl M, et al. High plasma levels of factor VIII and risk of recurrent thromboembolism. N Engl J Med 2000; 343: 457–62.
O’Donnell J, Mumford AD, Manning RA, Laffan M. Elevation of FVIII: C in venous thromboembolism is persistent and independent of the acute phase reaction. Thromb Haemost 2000; 83: 10–3.
O’Donnell J, Tuddenham EG, Manning R, Kemball-Cook G, Johnson D, Laffan M. High prevalence of elevated factor VIII levels in patients referred for thrombophilia screening: role of increased synthesis and relationship to the acute phase reaction. Thromb Haemost 1997; 77: 825–8.
Kamphuisen PW, Eikenboom JC, Vos HL, et al. Increased levels of factor VIII and fibrinogen in patients with venous thromboembolism are not caused by acute phase reactions. Thromb Haemost 1999; 81: 680–3.
Asherson RA. Antiphospholipid antibodies and syndromes. In: Systemic lupus erythematosus, 2nd ed (Lahita RG, editor). New York: Churchill Livingstone; 1992. p. 587–635.
Levine JS, Branch DW, Rauch J. Antiphospholipid antibody syndrome. N Engl J Med 2002; 346: 752–63.
Kim V, Spandorfer J. Epidemiology of venous thromboembolic disease. Emerg Med Clin North Am 2001; 19: 839–59.
Goldenberg NA, Knapp-Clevenger R, Manco-Johnson MJ. Elevated plasma factor VIII and d-dimer levels as predictors of poor outcomes of thrombosis in children. N Engl J Med 2004; 351: 1081–8.
Ridker PM. Inherited risk factors for venous thromboembolism: implications for clinical practice. Clin Cornerstone 2002; 4: 18–30.(Robert S. Bobrow, MD)
Abstract
Background: Elevations of coagulation factor VIII have recently been described in significant numbers of patients with venous thromboembolism (VTE) previously thought to have had an "idiopathic" event. Three patients from a family practice are presented with recurrent VTE and increased factor VIII levels.
Method: The case histories and results of laboratory tests were reviewed.
Results: The 3 patients had no other clear coagulopathy. In 2 of the 3, the increase was confirmed with a second reading.
Conclusions: Factor VIII assay should be considered in the work-up of idiopathic, recurrent VTE. Long-term anticoagulation may be appropriate in this setting.
References
Locke CF and Evans NC. Evaluating idiopathic venous thromboembolism: what is necessary, what is not. J Fam Pract 2003; 52: 770–6.
Ridker PM, Militich JP, Hennekens CH, Buring JE. Ethnic distribution of factor V Leiden in 4047 men and women. Implications for venous thromboembolism screening. JAMA 1997; 277: 1305–7.
Koster T, Blann AD, Briet E, Vandenbroucke JP, Rosendaal FR. Role of clotting factor VIII in effect of von Willebrand factor on occurrence of deep-vein thrombosis. Lancet 1995; 345: 152–5.
Kraaijenhagen RA, in’t Anker PS, Koopman MM, et al. High plasma concentration of factor VIIIc is a major risk factor for venous thromboembolism. Thromb Haemost 2000; 83: 5–9.
Kyrle PA, Minar E, Hirschl M, et al. High plasma levels of factor VIII and risk of recurrent thromboembolism. N Engl J Med 2000; 343: 457–62.
O’Donnell J, Mumford AD, Manning RA, Laffan M. Elevation of FVIII: C in venous thromboembolism is persistent and independent of the acute phase reaction. Thromb Haemost 2000; 83: 10–3.
O’Donnell J, Tuddenham EG, Manning R, Kemball-Cook G, Johnson D, Laffan M. High prevalence of elevated factor VIII levels in patients referred for thrombophilia screening: role of increased synthesis and relationship to the acute phase reaction. Thromb Haemost 1997; 77: 825–8.
Kamphuisen PW, Eikenboom JC, Vos HL, et al. Increased levels of factor VIII and fibrinogen in patients with venous thromboembolism are not caused by acute phase reactions. Thromb Haemost 1999; 81: 680–3.
Asherson RA. Antiphospholipid antibodies and syndromes. In: Systemic lupus erythematosus, 2nd ed (Lahita RG, editor). New York: Churchill Livingstone; 1992. p. 587–635.
Levine JS, Branch DW, Rauch J. Antiphospholipid antibody syndrome. N Engl J Med 2002; 346: 752–63.
Kim V, Spandorfer J. Epidemiology of venous thromboembolic disease. Emerg Med Clin North Am 2001; 19: 839–59.
Goldenberg NA, Knapp-Clevenger R, Manco-Johnson MJ. Elevated plasma factor VIII and d-dimer levels as predictors of poor outcomes of thrombosis in children. N Engl J Med 2004; 351: 1081–8.
Ridker PM. Inherited risk factors for venous thromboembolism: implications for clinical practice. Clin Cornerstone 2002; 4: 18–30.(Robert S. Bobrow, MD)