Impact of screening on thrombophilia for patients with venous thrombosis.
OBJECTIVE
The epidemiologic importance of thrombophilia on venous thromboembolism (VTE) has been extensively studied. We tried to identify the variables that point to the positive test results for thrombophilia and the impact of these results on clinical decisions.


METHODS
Thrombophilia screening was applied to 84 consecutive patients with VTE. After test results, two independent observers evaluated, in a case by case basis, the indication of a change on prophylaxis or special attention, in order to modify the period of anticoagulant intake or have a higher medical surveillance before risk situations or for the extension of the research to the first degree relatives.


RESULTS
Thrombophilia was found in 41.66% (35/84), and in 32.12% (27/84) it involved a genetic cause. The factor V Leiden was found in 15.47%, followed by the natural anticoagulant dysfunction (11.9%). There was no significative difference of thrombophilia frequency between ages, nor a difference of age in the onset of the first thrombotic event between thrombophilic and non-thrombophilic patients. There was a higher prevalence of thrombophilia in patients with superficial thrombophlebitis of spontaneous onset and in cases of recurrence. The change on prophylaxis resulted in 7.14% (6/84) and special attention in 40.47% (34/84).


CONCLUSIONS
Spontaneous superficial thrombophlebitis, occurrence of VTE related to non surgical causes, and recurrence, were the main findings which suggested thrombophilia. The change of prophylaxis was applied to a small percentage of patients. The special attention for risk situations and the extension of the primary prophylaxis to the asymptomatic family members seems to be the best indication for the laboratory research on thrombophilia.
Paschôa
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AF
Department of Surgery, School of Medicine Campinas State University, São Paulo, Brazil. adilsonpaschoa@uol.com.br
Guillaumon
A T
AT
D000367:Age Factors; D001779:Blood Coagulation Factors / Q000235:genetics; D005165:Factor V / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009154:Mutation; D015588:Observer Variation; D015995:Prevalence; D012008:Recurrence; D012307:Risk Factors; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control; D019851:Thrombophilia / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics / Q000503:physiopathology; D020246:Venous Thrombosis / Q000150:complications* / Q000453:epidemiology / Q000235:genetics / Q000503:physiopathology
D001779:Blood Coagulation Factors; C095381:factor V Leiden; D005165:Factor V