Materiały źródłowe

• #1 Factor V Leiden Thrombophilia – GeneReviews® – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK1368/

  Prevention of primary manifestations: In the absence of a history of thrombosis, long-term prophylactic anticoagulation is not routinely recommended for asymptomatic factor V Leiden variant heterozygotes. A short course of prophylactic anticoagulation when transient risk factors are present may prevent initial thrombosis in heterozygotes. […] Selected factor V Leiden variant heterozygotes who do not require long-term anticoagulation may benefit from evaluation prior to exposure to circumstantial risk factors such as surgery or pregnancy. Recommendations for prophylaxis at the time of surgery and other high-risk situations are available in consensus guidelines. […] Women with a history of VTE who are heterozygous for the factor V Leiden variant should avoid estrogen-containing contraception and hormone replacement therapy (HRT). Women homozygous for the factor V Leiden variant with or without prior VTE should avoid estrogen-containing contraception and HRT.

• #2 Factor V Leiden: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17896-factor-v-leiden

  No, you cant prevent this blood clotting disorder. There currently arent any genetic treatments that can stop someone from inheriting a mutated F5 gene. […] Individuals who happen to know that they have factor V Leiden but have never had blood clots dont have to be prescribed any blood thinners. But its important that these individuals discuss with their doctors what they should be aware of and what they can do to minimize the risk of DVT or PE. Some issues that can be discussed with your doctor include: […] Effective measures to eliminate or reduce other risk factors for DVT or PE, such as smoking cessation, weight loss and having a more active lifestyle. […] The need (or not) to wear graded elastic compression stockings during long-haul flights and long road trips. […] Avoidance of alcohol-containing beverages during long flights.

• #3 Factor V Leiden thrombophilia | Genetics in Medicine

  https://www.nature.com/articles/gim920112

  In the absence of a history of thrombosis, long-term anticoagulation is not routinely recommended for asymptomatic Factor V Leiden heterozygotes, although prophylactic anticoagulation may be considered in high-risk clinical settings. […] Decisions regarding prophylactic anticoagulation should be based on a risk/benefit assessment in each individual case. Recommendations for prophylaxis at the time of surgery and other high-risk situations are available in consensus guidelines. […] Prophylactic anticoagulation is not routinely recommended in asymptomatic heterozygous women with no history of thrombosis. […] Prophylactic anticoagulation should also be considered for heterozygous women with a prior estrogen-related thrombosis who are also at increased risk for recurrence. […] The results of observational studies and two randomized trials suggest that prophylaxis with LMWH may improve pregnancy outcome in women with thrombophilia and a history of unexplained recurrent miscarriage or late pregnancy loss. […] There is currently no evidence that antithrombotic therapy reduces the risk of preeclampsia or other pregnancy complications in women with thrombophilia including Factor V Leiden.

• #4 Article – Response to Comments: Testing for Hypercoagulability/Thrombophilia (Factor V Leiden, Factor II prothrombin, and MTHFR) (A54586)

  https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=54586&ver=2

  Prophylactic anticoagulation is recommended for women with a factor V Leiden allele and a history of unprovoked VTE. Unfractionated or low molecular-weight heparin should be given during pregnancy, followed by a four- to six-week course of anticoagulation post-partum. […] Prophylactic anticoagulation should be considered for heterozygous women with a prior estrogen-related thrombosis who are also at an increased risk for recurrence. […] Prophylactic anticoagulation also should be considered for asymptomatic women with homozygous factor V Leiden or double heterozygosity for factor V Leiden and the prothrombin 20210GA mutation, or with other combined thrombophilic defects, especially those with circumstantial risk factors (obesity, immobilization, multiple gestation). […] The American College of Chest Physicians (ACCP) notes the following recommendations: In person with asymptomatic thrombophilia (e.g., without a previous history of VTE), ACCP recommends against the long-term daily use of mechanical or pharmacologic thromboprophylaxis to prevent VTE.

• #5 Factor V Leiden – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/factor-v-leiden/diagnosis-treatment/drc-20372428

  Your doctor might suggest that you take extra precautions to prevent blood clots if you have the factor V Leiden mutation and are going to have surgery. These precautions might include: […] Some precautions to help reduce your risk of blood clots include: […] Be cautious with estrogen. Oral contraceptives or estrogen replacement therapy can increase the risk of blood clots on their own, so be sure to discuss the risks and the benefits of estrogen-containing medications with your doctor if you have factor V Leiden. […] If your factor V Leiden requires you to take anticoagulant medication, here are some steps that might help you prevent injury and avoid excessive bleeding: […] Do I need to take medication to prevent additional blood clots?

• #6 Treatment for Factor V Leiden, Stuck Between a Rock and a Hard Place: A Case Report and Review of Literature | Jehangir | Journal of Hematology

  https://thejh.org/index.php/jh/article/view/149/103

  Factor V Leiden thrombophilia is diagnosed either by using a coagulation screening test or by DNA analysis of F5, which encodes the factor V protein. […] Managing this disorder is challenging, because the current treatment regimen available can increase the patients chance of bleeding. […] In the absence of a history of thrombosis, long-term prophylactic anticoagulation is not routinely recommended for asymptomatic factor V Leiden heterozygotes. Patients should be counseled about eliminating certain risk factors like smoking and educated on the signs and symptoms of a DVT or PE so that early diagnosis and treatment may be instituted. […] When risk factors are present, a short course of prophylactic anticoagulation may prevent initial thrombosis. […] For patients with confirmed deep vein thrombosis or pulmonary embolism, anticoagulant therapy with subcutaneous low molecular-weight heparin, monitored IV, or subcutaneous unfractionated heparin or fondaparinux can be used.

• #7 Factor V Leiden Information – Milton Keynes University Hospital

  https://www.mkuh.nhs.uk/patient-information-leaflet/factor-v-leiden-information

  People with Factor V Leiden do not need treatment unless there is a blood clot. In this case the doctor will prescribe medication (anticoagulant) to make the blood take longer to clot. Treatment will usually last 3-6 months but may be longer depending on the individual circumstances. […] If you require surgery or are immobile/bed bound tell your doctor you carry the Factor V Leiden gene as treatment to prevent thrombosis is likely to be recommended. […] The risk of thrombosis on the combined pill is small but four times that of the general population so women who also carry the Factor V Leiden gene should use an alternative contraceptive method. This is particularly important if they or a first degree relative have had a thrombosis. […] As pregnancy is a risk factor for thrombosis, if you have had a clot it is likely you will have low molecular weight heparin injections throughout pregnancy and the 6 weeks after birth. It is therefore important that you tell your doctor/midwife early that you are pregnant, or ideally before. […] If you are not on treatment it is important that you let your doctor know your Factor V Leiden status if you are hospitalised.

• #8 Factor V (Five) Leiden Mutation | Fact Sheets

  https://www.melbournehaematology.com.au/fact-sheets/factor-v-five-leiden-mutation.html

  Factor V Leiden mutation is an inherited condition (i.e. from your parents). We inherited one copy of each gene from each of our parents. One (or both) of your parents will have passed the Factor V Leiden mutation on to you and you may pass the condition onto your children. […] Most people who have Factor V Leiden mutation do not need any treatment but need to be careful at times when the risk of getting a blood clot may be increased (e.g. after surgery, during long flights etc). […] Maintaining a healthy weight, stopping smoking, staying active and keeping any other medical conditions under control should also help you protect against getting any blood clots. […] You should tell your doctor or surgeon that you have the Factor V Leiden mutation before any operations or prolonged periods of bed rest. […] Testing is easily done a simple blood test is all that is required. Most people think testing is a good idea but you and your family should think carefully about testing for the Factor V Leiden mutation.

• #9 VTE Prevention for Patients Undergoing Major Orthopedic Surgery

  https://www.acc.org/Education-and-Meetings/Patient-Case-Quizzes/2021/11/30/13/58/VTE-Prevention-for-Patients-Undergoing-Major-Orthopedic-Surgery

  Most patients undergoing hip replacement surgery should receive thromboprophylaxis with either aspirin or an anticoagulant medication, according to recent guideline documents. […] Guidelines suggest that direct oral anticoagulants (DOACs) be used preferentially over low-molecular-weight heparin and warfarin when anticoagulation therapy is given. […] For patients at high risk of venous thromboembolism, a 35-day course of anticoagulation is appropriate.

• #10 Factor V Leiden Thrombophilia – GeneReviews® – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK1368/

  In women heterozygous for the factor V Leiden variant, antepartum prophylactic anticoagulation is not suggested for first VTE prevention, regardless of family history of VTE. In women homozygous for the factor V Leiden variant, antepartum prophylactic anticoagulation is suggested to prevent a first VTE, regardless of family history of VTE. In double heterozygous women for the factor V Leiden and F2 20210GA variants, antepartum prophylactic anticoagulation is suggested to prevent a first VTE, regardless of family history of VTE.

• #11 Factor V Leiden – Blood Clots

  https://www.stoptheclot.org/learn_more/factor-v-leiden-2/

  Women have a greater chance of developing a blood clot during pregnancy. Before becoming pregnant, talk with your doctor about how your risk of blood clots can be managed during pregnancy, childbirth and for six weeks postpartum. You may be treated with blood thinners during this time. […] Hormones and birth control pills also increase women’s risk of blood clots. Talk with your doctor about the risks and benefits of taking these medications.

• #12 Article – Response to Comments: Testing for Hypercoagulability/Thrombophilia (Factor V Leiden, Factor II prothrombin, and MTHFR) (A54586)

  https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=54586&ver=2

  For pregnant women with no prior history of VTE who are known to be homozygous for factor V Leiden or the prothrombin 20210A mutation and have a positive family history for VTE, we suggest antepartum prophylaxis with prophylactic or intermediate-dose low molecular-weight heparin (LMWH) and postpartum prophylaxis for 6 weeks with prophylactic or intermediate-dose LMWH or vitamin K antagonists (VKAs) targeted at INR 2.0 to 3.0 rather than no prophylaxis. […] For all pregnant women with prior VTE, we suggest postpartum prophylaxis for 6 weeks with prophylactic or intermediate-dose LMWH or VKAs targeted at INR 2.0 to 3.0 rather than no prophylaxis. […] For pregnant women at moderate to high risk of recurrent VTE (single unprovoked VTE, pregnancy or estrogen-related VTE, or multiple prior unprovoked VTE not receiving long-term anticoagulation), we suggest antepartum prophylaxis with prophylactic or intermediate-dose LMWH rather than clinical vigilance or routine care.

• #13 Pregnancy, thrombophilia, and the risk of a first venous thrombosis: systematic review and bayesian meta-analysis | The BMJ

  https://www.bmj.com/content/359/bmj.j4452

  Women with antithrombin, protein C, or protein S deficiency or with homozygous factor V Leiden should be considered for antepartum or postpartum thrombosis prophylaxis, or both. […] Women with heterozygous factor V Leiden, heterozygous prothrombin G20210A mutation, or compound heterozygous factor V Leiden and prothrombin G20210A mutation should generally not be prescribed thrombosis prophylaxis on the basis of thrombophilia and family history alone. […] These data should be considered in future guidelines on pregnancy associated VTE risk.

• #14 Article – Response to Comments: Testing for Hypercoagulability/Thrombophilia (Factor V Leiden, Factor II prothrombin, and MTHFR) (A54586)

  https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=54586&ver=2

  Prophylactic anticoagulation is recommended for women with a factor V Leiden allele and a history of unprovoked VTE. Unfractionated or low molecular-weight heparin should be given during pregnancy, followed by a four- to six-week course of anticoagulation post-partum. […] Prophylactic anticoagulation should be considered for heterozygous women with a prior estrogen-related thrombosis who are also at an increased risk for recurrence. […] Prophylactic anticoagulation also should be considered for asymptomatic women with homozygous factor V Leiden or double heterozygosity for factor V Leiden and the prothrombin 20210GA mutation, or with other combined thrombophilic defects, especially those with circumstantial risk factors (obesity, immobilization, multiple gestation). […] The American College of Chest Physicians (ACCP) notes the following recommendations: In person with asymptomatic thrombophilia (e.g., without a previous history of VTE), ACCP recommends against the long-term daily use of mechanical or pharmacologic thromboprophylaxis to prevent VTE.

• #15 Thrombophilias in Pregnancy Treatment & Management: Approach Considerations, Consultations, Long-Term Monitoring

  https://emedicine.medscape.com/article/2056429-treatment

  The decision to provide thromboprophylaxis to pregnant patients depends on the following: […] High-risk thrombophilia (antithrombin deficiency, homozygous factor V Leiden, homozygous prothrombin mutation G20210A, double heterozygous factor V Leiden and prothrombin mutation G20210A) without prior VTE: Prophylactic LMWH or UFH […] A systematic review by Croles et al reported that antepartum or postpartum thrombosis prophylaxis, or both should be considered for women with antithrombin, protein C, or protein S deficiency or with homozygous factor V Leiden. […] For patients who meet the criteria for obstetric antiphospholipid syndrome, the American College of Rheumatology (ACR) strongly recommends combined lowdose aspirin and prophylacticdose heparin (usually LMWH). […] Estrogen-containing contraception has been shown to increase the risk of VTE 35-99 times above baseline. Therefore, estrogen-based contraception is contraindicated in a patient with a history of VTE or thrombophilia. […] Contraceptive methods, including progestin-containing contraceptives, may be considered in women with a prior VTE or known thrombophilia.

• #16 Factor V Leiden: Symptoms, Diagnosis and Treatment

  https://www.nationwidechildrens.org/conditions/factor-v-leiden

  Since Factor V Leiden is an inherited condition, there is no way to prevent it. However, there are certain lifestyle changes one can make to reduce the risk of abnormal clot formation. Regular physical activity and avoidance of staying in a single position for a long period of time can reduce the risk of abnormal clots. Those on long car trips and airplane flights should stand up and move about on a regular basis. Estrogen-containing birth control medications and cigarette smoking are other risk factors that should be avoided.

• #17 Factor V Leiden: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17896-factor-v-leiden

  Counseling prior to taking birth control pills or before becoming pregnant. […] You can help lower your risk of blood clots with lifestyle changes, including: […] Avoid smoking, vaping and tobacco use. Ask your provider for resources to help you quit. […] Drink enough water so you stay hydrated. […] Limit alcohol intake, and avoid it during long flights (it can lead to dehydration). […] Keep a weight thats healthy for you. […] Move around more. Try to build up to 150 minutes of moderate-intensity exercise (like walking) per week. […] Stand up and walk around during long flights. Take frequent breaks during long car rides to get out and stretch your legs. If you cant walk around, flex your ankles and point your toes up and down. […] Wear compression stockings if your provider prescribes them for you. Dont buy ones from the store or wear them without talking to your provider first.

• #18 Factor V Leiden – American Blood Clot Association

  https://bloodclot.org/factor-v-leiden/

  Individuals with Factor V Leiden can take certain lifestyle measures and preventative steps to help manage their condition and reduce the risk of blood clot formation. While these measures may not eliminate the risk entirely, they can play a significant role in promoting overall health and well-being. […] One important lifestyle change is maintaining a healthy weight. Obesity is known to increase the risk of blood clot formation, so losing weight and maintaining a healthy BMI can help minimize this risk. Regular exercise is also crucial, as it helps improve circulation and reduces the likelihood of blood clots. Engaging in moderate-intensity activities such as walking, swimming, or cycling for at least 30 minutes most days of the week can have a positive impact. […] In addition to lifestyle changes, individuals with Factor V Leiden may also need to take preventative measures in certain situations. For example, during long periods of immobilization such as plane or car rides, it is important to move around and perform leg exercises to improve blood circulation. Wearing compression stockings can also help prevent blood from pooling in the legs and reduce the risk of clots.

• #19 Factor V Leiden: Signs, Symptoms and Treatment

  https://www.nationwidechildrens.org/conditions/factor-v-leiden-2

  Since Factor V Leiden is an inherited condition, there is no way to prevent it. There are, however, lifestyle choices that reduce the risk of abnormal blood clots: […] Get regular physical activity. […] If on a long airplane flight, stand up and move around regularly. […] If on a long car trip, stop about every 2 hours and walk for a few minutes. […] Avoid estrogen-containing birth control. […] Do not smoke cigarettes.

• #20 Factor V Leiden – Blood Clots

  https://www.stoptheclot.org/learn_more/factor-v-leiden-2/

  There is no treatment that can prevent this disorder or make it go away. However, there are things that you can do to reduce your chances of developing a dangerous blood clot. […] In situations where there is a greater chance of clotting (such as surgery, a leg cast, a serious illness or pregnancy) you may be treated with blood thinners until the risk has passed. […] Keep your weight in a healthy range […] Build physical activity into your daily life […] Take care when traveling long distances […] Do not smoke […] Serious illness, casts and surgery can increase your chances of developing blood clots. When you need health care or go to the hospital, tell your healthcare team that you have factor V Leiden, so that they can plan the care you need. You may be treated with blood thinners until the risk has passed.

• #21 Factor V Leiden mutation

  https://www.aboutkidshealth.ca/factor-v-leiden-mutation

  Although there is no direct treatment for the FVL mutation, preventative measures like exercise, a healthy diet, and avoiding smoking and/or alcohol consumption, are some ways that the risk for developing blood clots can be reduced. […] The following measures may be taken to prevent blood clots: […] Maintain a healthy diet. Talk to your child’s health-care team before changing your child’s diet and follow Canada’s Food Guide where applicable. Any irregular weight gain can contribute to the poor circulation of blood in the veins, increasing the risk of blood clots. […] Smoking and binge drinking or excessive alcohol consumption should be avoided. […] When travelling, encourage your child to walk around whenever possible. Decreased circulation of blood flow can increase the risk for blood clots.

• #22 Factor V Leiden | The Foundation to Advance Vascular Cures

  https://www.vascularcures.org/factor-v-leiden

  Drink water: Being dehydrated causes our blood vessels to narrow and the blood to thicken. Staying hydrated helps to improve our circulation. If your doctor or provider has advised you to be on a fluid restriction, its important to stay within your recommended fluid intake. […] Raise your legs: From time to time, when you are laying down, prop your legs on a pillow (or two) to elevate them above the heart. Stay in this position for about 15-20 minutes at a time. […] Wear compression stockings: If youre at high risk for clots, compression stockings help promote better circulation. These stockings typically require a prescription so make sure to discuss it with your provider. […] Lifestyle and diet changes: Smoking causes your blood vessels to narrow and too much salt in your diet can dehydrate you. A healthy, balanced diet and limiting salty and fried foods can decrease your risk for clots. Limiting certain habits such as smoking and drinking alcohol can also improve your overall health.

• #23

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf8198

  Factor V Leiden is the most common inherited condition causing increased blood clotting. It increases the chances that your blood will form abnormal blood clots that can be dangerous. […] Your treatment may include a medicine (called a blood thinner) that prevents blood clots. […] If you take a blood thinner, be sure you get instructions about how to take your medicine safely. Blood thinners can cause serious bleeding problems. […] Check with your doctor about whether you should use hormone forms of birth control or hormone therapy. These may increase your risk of blood clots. […] Do not smoke. It can increase the risk of blood clots. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

• #24 Review of Factor V Leiden Thrombophilia

  https://www.uspharmacist.com/article/review-of-factor-v-leiden-thrombophilia

  Current management strategies involve the use of pharmacotherapy, when indicated, in the event of deep venous thrombosis or pulmonary embolism. […] Treatment guidelines have specific recommendations regarding the use of oral anticoagulant therapy for the treatment and prevention of VTE events. […] Testing for thrombophilia is recommended when the results are needed to improve or modify management. […] Current guidelines do not address empiric therapy with anticoagulants for those individuals who have not yet experienced thrombosis. […] The use of anticoagulant therapy for 3 months is recommended in the following instances: patients who experience proximal DVT of the leg or PE that is provoked by surgery; proximal DVT of the leg or PE provoked by a nonsurgical transient risk factor; patients who experience isolated distal DVT of the leg provoked by surgery or a nonsurgical transient risk factor; and in patients with an unprovoked DVT of the leg (isolated distal or proximal) or PE.

• #25 Article – Response to Comments: Testing for Hypercoagulability/Thrombophilia (Factor V Leiden, Factor II prothrombin, and MTHFR) (A54586)

  https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=54586&ver=2

  Long-term anticoagulation should be considered in individuals homozygous for the factor V Leiden mutation or with multiple thrombophilic disorders. In these individuals at high risk for recurrence, the potential benefits from long-term warfarin may outweigh the bleeding risks. Prophylactic anticoagulation should be considered in high-risk clinical settings such as surgery, pregnancy, or prolonged immobilization, although currently no evidence confirms the benefit of primary prophylaxis for all asymptomatic carriers. […] Prophylactic anticoagulation during pregnancy is not routinely recommended in asymptomatic heterozygous women with no history of thrombosis. These women should be warned about potential thrombotic complications, counseled about the risks and benefits of anticoagulation during pregnancy, and offered a four- to six-week course of anticoagulation after delivery, as the greatest thrombotic risk is in the initial postpartum period.

• #26 Factor V Leiden – Wikipedia

  https://en.wikipedia.org/wiki/Factor_V_Leiden

  As there is no cure yet, treatment is focused on prevention of thrombotic complications. Anticoagulants are not routinely recommended for people with heterozygous factor V Leiden, unless there are additional risk factors present, but are given when such an event occurs. A single occurrence of deep vein thrombosis or pulmonary embolism in people with factor V Leiden warrants temporary anticoagulant treatment, but generally not lifelong treatment. […] In addition, temporary treatment with an anticoagulant such as heparin may be required during periods of particularly high risk of thrombosis, such as major surgery. […] People with homozygous factor V Leiden or heterozygous factor V Leiden with additional thrombophilia however should be considered for lifelong oral anticoagulation.

• #27 Review of Factor V Leiden Thrombophilia

  https://www.uspharmacist.com/article/review-of-factor-v-leiden-thrombophilia

  In patients whose first VTE is unprovoked proximal DVT of the leg or PE and who have a low or moderate bleeding risk, the recommendation is extended anticoagulant therapy (no scheduled stop date); for those who have a high bleeding risk, the recommendation is 3 months of therapy. […] Current oral pharmacotherapy options available for coagulopathy due to factor V Leiden include vitamin K antagonists and direct oral anticoagulants (DOACs) such as direct thrombin inhibitors and factor Xa inhibitors. […] Warfarin is indicated for both the prophylaxis and treatment of venous thrombosis and PE. […] The goal of anticoagulant therapy is to prevent further propagation of the clot and reduce the complication of the formed clot embolizing and traveling to another part of the body. […] Betrixaban is indicated for the prophylaxis of VTE in adult patients who are at risk for thromboembolic complications while hospitalized for an acute medical illness that restricts mobility. […] Pharmacists are knowledgeable regarding the available anticoagulant options and are able to monitor for duplications of therapy or additional nonprescription agents that may put a patient at increased risk for bleeding complications.

• #28 Factor V Leiden

  https://wholeheartfamilymed.com/advanced-testing/blood-work/genetics/factor-v-leiden

  Factor V Leiden (Prevalence: 1% homozygous, 5% heterozygous) […] This genetic test identifies individuals with a defect in clotting factors. Patients with an abnormal Factor V Leiden gene are at increased risk of developing blood clots (which can lead to heart attacks, strokes, or pulmonary embolisms). These patients should consider more aggressive thrombosis (clot) prevention measures than the average individual. Effective anticoagulant therapy can diminish the risk of these potentially life-threatening events. […] In order for these patients to lower their risk of developing a blood clot, patients need to stay hydrated and remain mobile. Long periods of inactivity can exacerbate risk, so when faced with long car rides, trans-continental flights, or illnesses that confine one to the bed, patients should make an effort to get up and walk around every couple of hours (or at least consider wearing compression stockings during these times to aid circulation). These patients may also benefit from daily aspirin therapy. […] Patients with this gene variant should notify all of their medical providers that they are carriers (particularly if they are pregnant or about to have surgery) because more aggressive anticoagulant therapy and monitoring may be necessary in certain circumstances.

• #29 Treatment for Factor V Leiden, Stuck Between a Rock and a Hard Place: A Case Report and Review of Literature | Jehangir | Journal of Hematology

  https://thejh.org/index.php/jh/article/view/149/103

  Long-term management of patients with inherited thrombophilia had not been well studied. […] There needs to be consistent evaluation of individuals on long-term anticoagulation to assess bleeding and assess risks versus benefits in treatment. […] There is a continuous need for consistent evaluation of individuals on long-term anticoagulation to assess bleeding and assess risks versus benefits in treatment. […] The possibility of creating a therapeutic balance remains an important area of research and great concern in order to provide hemodynamic stability in patients with factor V Leiden mutation.

• #30 Get Tested For Factor V Leiden | Blood Clots

  https://bloodclot.org/factor-v-leiden-blood-clots/

  Testing for Factor V Leiden is of utmost importance for individuals at risk or with a family history of blood clotting disorders. By knowing your genetic status, you can make informed decisions about your treatment and prevention strategies. […] Early detection of Factor V Leiden can significantly reduce the risk of developing abnormal blood clots and the associated complications. It allows you and your healthcare provider to create a personalized plan to manage your condition and prevent potentially life-threatening events. […] Remember, knowing your Factor V Leiden status can empower you to make informed decisions about your health and take proactive steps towards preventing potential complications. Stay informed and take control of your health by getting tested for Factor V Leiden. […] Ultimately, the decision to undergo Factor V Leiden testing is a personal one. By weighing the potential benefits and drawbacks, considering your own readiness for the outcomes, and consulting with your healthcare provider, you can make an informed decision that aligns with your health goals and priorities.

• #31 American College of Medical Genetics Consensus Statement on Factor V Leiden Mutation Testing | Genetics in Medicine

  https://www.nature.com/articles/gim200128

  When appropriate clinical care requires testing for the factor V Leiden allele, either direct DNA-based genotyping or a factor V Leiden-specific functional assay is recommended. Patients who test positive by a functional assay should then be further studied with the DNA test for confirmation and to distinguish heterozygotes from homozygotes. […] Factor V Leiden testing is recommended in women with venous thromboembolism during pregnancy or oral contraceptive use. […] Knowledge that they have factor V Leiden may influence management of pregnancy and may be a factor in decision-making regarding oral contraceptive use. […] Women with a history of recurrent late-trimester fetal loss should also be considered for testing. […] Screening of asymptomatic individuals with other recognized environmental risk factors such as surgery, trauma, paralysis, and malignancy is not necessary or recommended, since all such individuals should receive appropriate medical prophylaxis for thrombosis regardless of carrier status.

• #32 American College of Medical Genetics Consensus Statement on Factor V Leiden Mutation Testing | Genetics in Medicine

  https://www.nature.com/articles/gim200128

  Patients testing positive for factor V Leiden or APC resistance should be considered for molecular genetic testing for the most common other thrombophilias with overlapping phenotype for which testing is easy and readily available. […] Physicians ordering factor V Leiden on a venous thrombosis patient for any of the indications recommended here should also consider the utility of functional, biochemical, and molecular screening for other heritable thrombophilic factors, especially prothrombin 20210A and plasma homocysteine levels. […] The factor V Leiden (R506Q) mutation is currently the only molecular analysis of the factor V gene indicated in the routine workup of thrombotic risk. […] Specific informed consent should not be required for factor V Leiden testing, but prior to testing, patients should be made aware that this is a genetic test, that test results have implications about risk in other family members, and that there may be attendant issues of confidentiality and possible insurance discrimination.

• #33 FVL|Recommendations|EGAPP|CDC

  https://archive.cdc.gov/www_cdc_gov/egappreviews/recommendations/FVL.html

  EGAPP Recommendation Statement: The EGAPP Working Group found adequate evidence to recommend against routine testing for Factor V Leiden (FVL) and/or prothrombin 20210GA (PT) in the following circumstances: (1) adults with idiopathic venous thromboembolism (VTE). In such cases, longer term secondary prophylaxis to avoid recurrence offers similar benefits to patients with and without one or more of these mutations. […] (2) Asymptomatic adult family members of patients with VTE and an FVL or PT mutation, for the purpose of considering primary prophylactic anticoagulation. Potential benefits are unlikely to exceed potential harms. The overall certainty of these findings was deemed moderate. The evidence was insufficient to determine whether FVL/PT testing might have clinical utility in some circumstances, such as for identifying FVL homozygosity among asymptomatic family members of adults with idiopathic VTE or counseling patients about the risks and benefits of antithrombotic therapy. Based on the available evidence, the certainty of net health benefit was deemed low. The recommendations do not extend to patients with other risk factors for thrombosis, such as contraceptive use, as the evidence review that serves as the basis for the recommendations focused primarily on idiopathic VTE.

• #34 Thromboembolic Disease and Factor V Leiden Defect | AAFP

  https://www.aafp.org/pubs/afp/issues/1998/0415/p1997.html

  Factor V Leiden mutation is rather common, affecting 3 to 7 percent of the population in Europe and the United States. […] The authors conclude that the issues associated with screening for factor V Leiden are complex. Screening protocols for primary prevention are likely to be inefficient because the lifetime risk for venous thromboembolism in the general population is low. […] Screening does appear to be appropriate in persons with a family or personal history of venous thrombotic episodes, especially if the person is found to be homozygous. […] Patients with venous thromboses must be screened for the presence of this mutation.

• #35 Factor V Leiden: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.factor-v-leiden-care-instructions.uf8198

  Factor V Leiden is the most common inherited condition that causes an increase in blood clotting. It increases the chances that your blood will form abnormal blood clots that can be dangerous. […] Your treatment may include a medicine (called a blood thinner) that prevents blood clots. A healthy lifestyle also can lower your risk of a blood clot. […] If you take a blood thinner, be sure you get instructions about how to take your medicine safely. Blood thinners can cause serious bleeding problems. […] Check with your doctor about whether you should use hormone forms of birth control or hormone therapy. These may increase your risk of blood clots. […] Have a healthy lifestyle. […] Do not smoke. It can increase the risk of blood clots. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

• #36 How to Prevent Blood Clots with Factor V Leiden – Doctronic, Your Trusted AI Doctor

  https://www.doctronic.ai/conditions-diseases/how-to-prevent-blood-clots-with-factor-v-leiden-j5hlWZ

  Factor V Leiden increases your risk of clotting, but preventive measures can minimize this risk. […] Simple lifestyle changes can significantly reduce clotting risks. Staying active, maintaining a healthy weight, and avoiding smoking are key preventive steps. […] In high-risk situations, such as surgery or pregnancy, doctors might recommend anticoagulants. These medications thin the blood, helping to prevent clot formation. […] Regular follow-ups with your healthcare provider can help manage risk. Monitoring involves staying alert to symptoms like unexplained swelling or pain, which can indicate a clot. […] Preventive measures are crucial in managing Factor V Leiden-related risks.

• #37

  https://www.healio.com/news/hematology-oncology/20120331/factor-v-leiden-mutation-increased-risk-for-thromboembolism-in-women-taking-tamoxifen

  Women with breast cancer assigned tamoxifen who experienced a thromboembolic event were five times more likely to carry the Factor V Leiden mutation when compared with matched controls taking tamoxifen who did not experience an event. […] Factor V Leiden mutations were identified in 18.5% of patients in the case group and 4.8% of controls (OR=4.66; P<.001). Factor V Leiden mutation was also associated with thromboembolism (OR=4.73; P<.001). [...] Continued follow-up and research on the relationship between the Factor V Leiden mutation and tamoxifen, especially in the prevention setting, will be the only way to clarify these apparently contradictory settings, he said.

• #38 Factor V Leiden mutation (recurrent miscarriage,prevention) – Primary Care Notebook

  https://primarycarenotebook.com/pages/obstetrics/factor-v-leiden-mutation-recurrent-miscarriageprevention

  There is some limited evidence that thrombophylaxis is effective in preventing recurrent miscarriages in women with factor V Leiden mutation. […] This study appears to show that thrombophylaxis improves pregnancy outcome in women with factor V Leiden mutation. However because of the numbers of women involved in the study and the uncontrolled design, the study results have to be considered with caution.

• #39 Internet Scientific Publications

  https://ispub.com/IJHE/15/1/56415

  After a review of the literature, it is presumed that both Factor V Leiden and vWF Disease can coexist in a patient. […] Factor 5 Leiden patients are often managed with secondary prevention with appropriate anticoagulation and modification of risk factors for thromboembolism. […] A case in the literature presents a woman who inherited both diseases. She was reported to suffer from Factor V Leiden and vWF Disease Type 1 in pregnancy. Her history was significant for easy bruising, but in this case, she was prescribed thromboprophylaxis with enoxaparin as pregnancy is a hypercoagulable state and as it has been documented that factor VIII and vWF levels normalize, removing any bleeding risk. […] Future research should focus on cases like these of combined thrombophillic-hemiphilic patients in order to provide better care for these unique presentations.

• #40 Factor V Leiden mutation

  https://www.aboutkidshealth.ca/factor-v-leiden-mutation

  Encourage your child to get regular physical activity. Children and youth typically need at least 60 minutes of moderate-to-vigorous intensity physical activity every day. […] If a child with FVL needs to take hormonal therapy (e.g., birth control pills), talk to a gynecologist about how they can be safely taken, in order to help reduce the risk of blood clots.

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