- The result whether positive or negative, rarely contributes to the management of any patient.
- Some 5 to 10% of the population, of European origin, will have a genetic 'thrombophilia' BUT very few ever develop thrombosis.
- Thrombophilia screening in unselected patients prior to oral contraceptive pills (OCP) or HRT use is not cost effective (screen 20,000 women to prevent 1 VTE, 2,000,000 to prevent 1 death).
- A 'negative' result does not exclude thrombophilia due to as yet unidentified causes.
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BCSH guidelines on Thrombophilia
Pregnancy- Regarding Management and Prevention of VTE
Only after appropriate counselling and the patient is in one of the categories below
- At Presentation of a thrombotic event - may give false positives.
- During anticoagulant therapy - will produce false positives.
- During Pregnancy - will produce false positives.
- During Oestrogen therapy (e.g. Oral contraceptive pills or HRT) - will produce false positives.
- In asymptomatic patients / family members under 18 years of age
- If the Patient has suffered only arterial thromboses - such thromboses are not associated with hereditary thrombophilia. Consider lupus anticoagulant & anticardiolipin antibody testing in such patients who present at an unusually young age.
|HRT||Hormone Replacement Therapy|