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Panminerva Medica 2002 June;44(2):107-13

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

Thrombosis: new culprits in an old disorder

Federman D. G., Moriarty J. P., Kravetz J. D., Kirsner R. S.

From the VA Connecticut Health Care System West Haven, CT, USA and Department of Medicine Yale University School of Medicine, New Haven, CT, USA *Department of Dermatology and Cutaneous Surgery Department of Epidemiology and Public Health University of Miami School of Medicine, Miami, FL, USA


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Venous throm­bo­sis is a ­cause of con­sid­er­able mor­bid­ity and mor­tal­ity. Over the ­past sev­er­al ­years, sev­er­al new caus­es of throm­bo­phil­ia ­have ­been iden­ti­fied and ­have dra­mat­i­cal­ly ­altered the ­approach to ­patients pre­sent­ing ­with throm­bo­sis. Newly ­described abnor­mal­ities asso­ciat­ed ­with throm­bo­phil­ia ­include the syn­drome of acti­vat­ed Protein C resis­tance (APCR), the pro­throm­bin 20210A muta­tion, hyper­hom­o­cys­tei­ne­mia, and ele­vat­ed lev­els of coag­u­la­tion fac­tors ­VIII and XI. Clinicians can now fre­quent­ly deter­mine caus­es of throm­bos­es ­that ­have pre­vi­ous­ly ­been ­deemed idiopath­ic. Though the ­risk fac­tors for VTE are becom­ing bet­ter ­defined, the ­cost-effec­tive ­approach to diag­no­sis and ther­a­peu­tic impli­ca­tions are not entire­ly ­clear at ­this ­point.

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