title: Recurrent venous thromboembolism in a patient with heterozygous factor v leiden mutation.
abstract: OBJECTIVE
  To report a patient case identifying risk for recurrent venous thromboembolism (VTE) associated with heterozygous Factor V Leiden mutation.
  
  
  METHODS
  A 54-year-old Caucasian male was diagnosed with heterozygous Factor V Leiden mutation in 2008 after experiencing a deep vein thrombosis (DVT) and bilateral pulmonary embolism. The patient was treated appropriately and started on anticoagulation therapy with warfarin through an anticoagulation management clinic. After approximately 17 months of warfarin therapy without incident, warfarin was discontinued. Within 2 months after discontinuation of anticoagulation therapy, the patient experienced his second DVT and left pulmonary artery embolus.
  
  
  CONCLUSIONS
  The risk of recurrent venous thromboembolism (VTE) in patients with heterozygous Factor V Leiden mutation is documented as an approximate 1.4-fold increase compared to patients without thrombophilia. However, the risk increases dramatically when nonreversible (age) or reversible risk factors (obesity, smoking, and long air flights) are present in this population.
  
  
  CONCLUSIONS
  Based on recent literature, heterozygous Factor V Leiden mutation exponentially increases the risk of recurrent VTE, especially in the presence of other risk factors. Health care providers should complete a comprehensive review of the patients' other risk factors when deciding on duration of anticoagulation therapy for patients with positive heterozygous Factor V Leiden mutation.
authors.affiliation: Assistant Professor of Pharmacy Practice, McWhorter School of Pharmacy, Samford University , Birmingham, Alabama ; Clinical Pharmacy Specialist, Adult Medicine, St. Vincent's Birmingham , Alabama.
authors.forename: C Whitney
authors.initials: CW
authors.lastname: White
authors.affiliation: Associate Professor of Pharmacy Practice, McWhorter School of Pharmacy, Samford University , Birmingham, Alabama.
authors.forename: Angela R
authors.initials: AR
authors.lastname: Thomason
authors.affiliation: Associate Professor of Pharmacy Practice, McWhorter School of Pharmacy, Samford University , Birmingham, Alabama ; Clinical Pharmacy Specialist, St. Vincent's East Family Medicine Residency , Birmingham, Alabama.
authors.forename: Valerie
authors.initials: V
authors.lastname: Prince
keywords: heterozygous Factor V Leiden mutation; venous thromboembolism; warfarin