Thrombosis

Thomas G. DeLoughery, MD

Oregon Health Sciences University, Portland, OR

This case was reviewed and updated in 2009 by Dr. Alvin H. Schmaier and members of the Teaching Cases Subcommittee.

Copyright of the American Society of Hematology, 2006. ISSN: 1931-6860.

III. LABORATORY DATA

It is important to recognize that when a patient presents with an acute venous thrombosis, the tests for the diagnosis of the mechanism for the thrombus should be performed when the patient is stable on anticoagulants or off oral anticoagulants for protein C or S defects/deficiencies and away from the acute, precipitating event. This patient had a workup during the acute event; therefore any abnormalities detected at that time will need to be confirmed when she is clinically stable.

Which of the following laboratory examinations should be ordered?

Complete Blood Count with platelets
Beta-HCG
aPTT (activated partial thromboplastin time) and PT (prothrombin time)
Antithrombin activity and antigen
Protein C activity and antigen
Free Protein S antigen
Factor V Leiden gene polymorphism
Anticardiolipin and anti-ß2-glycoprotein 1 antibodies and lupus anticoagulant assays
Prothrombin 20210 gene polymorphism
Urinalysis

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