 |
| FAQ
: Thrombosis |
  |
|
|
• |
In
patients with a documented venous thrombosis problem
:
|
| y |
-
aafter a first thrombotic incident before the age of 40, |
| y |
-
after any kind of spontaneous thrombosis without any clear
trigger factor, |
| y |
-
when a thrombus is found in an unusual location, |
| y |
-
when thrombosis is recurrent, especially if it repeatedly
involves the same territory,
|
| y |
-
if there is a family history of thrombosis , |
| y |
-
when there is a link between thrombosis and spontaneous
abortion (recurrent),, |
| y |
-
when there is a history of necrosis of the skin having
been induced by AVK, |
| y |
-
llin patients who fail to respond to heparin treatment. |
| y |
y |
|
• |
When
arterial thrombosis is seen in patients of under 50
years of age : :
|
| y |
-
with no underlying atherosclerosis, |
| y |
-
when recurrent despite anticoagulant treatment, |
| y |
-
if there is a family history of venous thrombosis. |
•
| |
• Non-specific
profile : : |
| y |
-
lors d'absence d'athérosclérose sous jacente, |
| y |
-
lors d'une récidive malgré un traitement
antithrombotique, |
| y |
-
lors d'antécédents familiaux de thrombose
veineuse. |
| y |
y |
|
|
• First-line
specific profil : |
| y |
-
activated protein C resistance ratio (the dynamic test
and/or genotyping for the Factor V Leiden mutation Q506), |
| y |
-
testing for circulating anticoagulant antibody, phospholipid,
anticardiolipid or anti-beta 2 GP1, |
| y |
-
protein C, protein S and antithrombin assays, y genotyping
for the G20210A mutation in the gene for prothrombin (Factor
II).
|
If
the first profile is negative and thrombotic disease is
strongly suspected :
|
 |
Un
bilan spécifique de deuxième intention:
|
| y |
-
Follow-up specific profile: , |
| y |
-
homocysteine levels, |
| y |
-
survey of family members, |
| y |
-
antigenic assay for physiological coagulation inhibitors,
|
| y |
-
blood group determination. |
•
|
• |
Choose
a time when blood clotting function is relatively stable
:
|
| y |
ideally, carry out the testing three months after the
thrombotic incident. y |
|
•
|
Always
wait after a course of treatment has been discontinued
: :
|
| y |
See
Table below.
|
| |
Antithrombin
II |
Protéin
C |
Protéin
S |
RPCa |
| Heparin |
10
days |
/ |
/ |
48
hours |
| AVK |
/ |
10
days |
3
weeks |
/ |
| Oestrogène |
1
months |
/ |
1
months |
1
months |
|
|
