19  Inherited Thrombophilias

Key Points
  • Test only if result changes management (extended AC, prophylaxis, pregnancy)
  • Don’t screen general population or determine CHC eligibility
  • Risks: cost, false reassurance (negative), anxiety (positive), false results
  • Tests inaccurate w/ acute VTE, heparin, DOACs, warfarin, pregnancy, liver disease, chemotherapy
  • Shared decision-making: patient must be well-informed

19.1 Introduction

Thrombophilia & hypercoagulable state: hereditary/acquired thrombosis predisposition

Key concepts: - Homozygous/heterozygous/compound heterozygous: zygosity determines risk - Heterozygotes lower risk than homozygotes - Compound heterozygosity (FVL + PGM): highest risk - Penetrance: genetic mutation presence ≠ clinical thrombosis - Incomplete for all inherited thrombophilias - Most mutations don’t cause VTE events

19.2 Epidemiology of Inherited Thrombophilias

Prevalence and risk of first and recurrent VTE
Thrombophilia Prevalence (%) Risk 1st VTE RR Recurrent VTE
AT deficiency 0.02 5-10 1.9-2.6
PC deficiency 0.2 4-6.5 1.4-1.8
PS deficiency 0.03-0.13 1-10 1.0-1.4
FVL heterozygous 3-7 3-5 1
FVL homozygous 0.02 9-12 1.0-2.6
PGM heterozygous 0.7-4 2-3 0.7-1.4
PGM homozygous 0.014 4 1.2
FVL + PGM compound 0.01 7-20 1.0-4.3

19.2.1 Factor V Leiden

FVL (F5 G1691A): - Prevalence: 3-8% European origin, 1.2% African American - Pathophysiology: G→A point mutation → ↑ prothrombin (133% normal) → ↑ APC resistance - Risk: 3-5 fold ↑ if heterozygous; substantially higher homozygous - Homozygous: 1 in 500-1600 of European origin

19.2.2 Prothrombin 20210 Mutation

PGM (F2 G20210A): - Prevalence: 0.7-4% Southern Europe, 2% USA, 0.5% African American - Pathophysiology: G→A outside coding region → ↑ prothrombin synthesis (133% normal) - Risk: 2-3 fold ↑ if heterozygous; varies homozygous - Geography: most common Southern European ancestry

19.2.3 Protein C Deficiency

PC (PROC): - Prevalence: 1 in 500-600 general population - Higher in: East Asian VTE populations (7.1%) - Challenge: homozygous extremely rare; heterozygotes more common - Clinical pearl: absent in newborns → potential DIC risk

19.2.4 Protein S Deficiency

PS (PROS1): - Prevalence: 1 in 800-3000 (true prevalence unknown due to testing difficulty) - Challenge: establishing normal PS range difficult; diagnosis accuracy limited - Higher in: East Asian VTE populations (8.3%) - Biology: PS exists free (active) & bound (inactive); proportions vary

19.2.5 Antithrombin Deficiency

AT (SERPINC1): - Mechanism: serine protease inhibitor; complexes w/ thrombin, Xa, IXa - Heparin effect: dramatically potentiates AT-protease complexes - Pathology: abnormal gene → impaired reactive site/heparin binding - Clinical: VTE + heparin resistance (unactivated factors) - Prevalence: rare; highest absolute thrombosis risk

19.3 Pathophysiology

19.3.1 Factor V Leiden (F5)

  • Mutation: G→A point mutation outside coding region
  • Defect: abolished APC resistance → ↑ Factor Va inactivation failure
  • Consequence: ↑ Factor V circulation → ↑ thrombin generation
  • Mechanism: Loss of APC inhibition → unopposed factor V activity

19.3.2 Prothrombin 20210 (F2)

  • Mutation: G→A outside coding region
  • Defect: molecule itself unaltered; ↑ synthesis (133% normal)
  • Consequence: ↑ thrombin → ↑ thrombosis risk

19.3.3 Protein C (PROC)

  • Dual defect: homozygous → inactivates Factors Va & VIIIa failure
  • Risk: ↑ thrombosis; severe deficiency → DIC in newborns
  • Mechanism: PC loss → unopposed factor Va/VIIIa amplification

19.3.4 Protein S (PROS1)

  • Dual cofactor role:
    • Cofactor for activated PC (inactivates Va/VIIIa)
    • Cofactor for tissue factor pathway inhibitor (inhibits Xa, VIIa)
  • Circulation states: free (active) 40%, bound (inactive) 60%
  • Acquired causes: ↓ free PS in acute phase, pregnancy
  • Consequence: ↑ unopposed Factor Va/VIII → ↑ thrombosis

19.3.5 Antithrombin (SERPINC1)

  • Normal function: inhibits Xa, IXa, XIa, XIIa via serine protease complexes
  • Heparin: accelerates AT-protease complex 1000-fold
  • Deficiency: ↓ natural anticoagulation → heparin resistance
  • Pathology: abnormal gene → reactive site/heparin binding defects

19.4 Compounding Risk Factors

VTE rarely isolated; accumulation of factors: - Inherited thrombophilia - Family history VTE - Exogenous estrogen - Pregnancy - Surgery/trauma/immobilization - Malignancy - Prolonged immobility

19.4.1 Family History of VTE

  • Risk: 1st-degree relative w/ VTE → 2-4 fold personal risk ↑
  • Definition: unprovoked VTE in relative increases risk more than provoked
  • Warning: negative thrombophilia test doesn’t eliminate family risk
  • Counseling: still recommend estrogen avoidance, immobility minimization

19.4.2 Pregnancy & Exogenous Estrogen

  • Heterozygous PGM: 3-15 fold ↑ VTE risk in pregnancy
  • Heterozygous FVL: similar magnitude ↑ risk
  • FVL + PGM compound: 8-18 fold ↑ risk
  • Homozygous states: 47 fold ↑ risk
  • All thrombophilias: ↑ risk w/ oral contraceptives & HRT

19.5 ASH Recommendations: Thromboprophylaxis in Pregnant Individuals

ASH thromboprophylaxis recommendations
Thrombophilia +Family Hx (A/P) -Family Hx (A/P)
Homozygous FVL ✓/✓ ✓/✓
FVL + PGM compound ✓/✓ ✓/✓
Homozygous PGM ✓/✓ X/X
AT deficiency ✓/✓ X/X
PC deficiency X/✓ X/X
PS deficiency X/✓ X/X
Heterozygous FVL X/X X/X
Heterozygous PGM X/X X/X

Footnote: Recommendations based on family history = 1st-degree VTE relative; negative family history = no VTE in FVL/PGM/AT deficiency relatives

Pregnant individual counseling: - Heterozygous FVL/PGM: minimize exogenous estrogen exposure - All thrombophilias: favor progestin-only over CHCs - High-risk (homozygous/compound): antepartum + postpartum prophylaxis - ASH against antepartum prophylaxis except high-risk states (see table)

19.6 Assays for Thrombophilia

Clinical Pearl: Interpreting Results

Test accuracy depends on clinical context. Abnormal results possible w/: - Acute VTE - Heparin/DOACs/warfarin - Pregnancy - Liver disease - Chemotherapy - Elevated Factor VIII - LAC or inhibitors

Always correlate w/ clinical presentation & timing.

19.6.1 Factor V Leiden & Prothrombin Mutations (F5, F2)

FVL screening: - aPC resistance assay: PTT/PT/Russell viper venom w/ normal plasma - Results: abnormally low ratio suggests resistance - Confirmatory: genotyping determines heterozygous vs homozygous - Pitfalls: false+ w/ elevated FVIII, estrogen, LAC; false- w/ anticoagulants

PGM screening: - Factor II activity assay: not sensitive - Standard: genetic testing (PCR/sequencing) - Advantages: detects heterozygous/homozygous; unaffected by medications

19.6.2 Protein C (PROC)

Activity assay (clot-based/chromogenic): - Clot-based: functional measure; affected by FVIII, PS, LAC variation - Chromogenic: synthetic substrate; detects Type I & some Type II defects - Pitfalls: false-low w/ warfarin, DOACs, elevated FVIII - Types: Type I (activity = antigen), Type II (activity < antigen)

Antigen assay: - Differentiates Type I from Type II deficiency - Repeat abnormal results; check during anticoagulation-free period

19.6.3 Protein S (PROS1)

Challenges: - Free vs bound states vary 40-60% w/ physiologic conditions - Pregnancy/acute phase: ↓ free PS (false-positive appearance) - Estrogen: ↓ free PS

Assays: - Clot-based activity: most sensitive; affected by same variables as PC - Free PS antigen: alternative; avoids activity assay confounders - Best: free PS antigen + activity if abnormal

19.6.4 Antithrombin (SERPINC1)

Activity assay (chromogenic): - Gold standard: heparin-enhanced chromogenic w/ Xa or IIa substrate - Functional measurement; most sensitive screening - Types: Type I (activity = antigen), Type II (activity < antigen), Type III (rare)

Interpretation: - Repeat abnormal results w/o heparin - Chromogenic w/o heparin differentiates Type IIa (reactive site) vs IIb (heparin binding) - LAC false-prolongs aPTT but does NOT exclude AT def; specific LAC testing needed

19.7 Reasons For & Against Testing

Risks and benefits of thrombophilia testing
For Against
Informs AC duration Rarely changes management
Identifies extended prophylaxis candidates False positive anxiety
Explains thrombosis to patient False negative reassurance
Suboptimal test performance
Poor medical advice based on results
Insurance/employment impact

19.8 Indications for Testing

Test if result changes management: - Pregnancy in patient w/ thrombophilia - Unprovoked VTE (may indicate extended AC) - Family history VTE (pregnancy/estrogen counseling) - Recurrent VTE despite prophylaxis

Don’t test: - Provoked VTE w/ major risk factor (surgery, trauma, immobility) - Asymptomatic relatives (low yield, high anxiety) - General population screening - Acute VTE/anticoagulation period

Shared decision-making essential: - Discuss false-positive anxiety & false-negative reassurance - Review management implications pre-testing - Document discussion & rationale

19.9 Treatment Implications

19.9.1 VTE w/ Provoked Event (Surgery/Trauma/Immobility)

Standard approach: - 3 months AC typical; rarely extend based on thrombophilia - Recurrence risk ~1 per 1000/year (low) - Bleeding risk 5-15 per 1000/year (higher) - Test recommendation: NOT indicated; doesn’t change duration

19.9.2 VTE Unprovoked

Consider if: - High thrombosis risk (recurrence ~10 per 1000/year) weighs against bleeding - Thrombophilia found → possible indefinite AC - Multiple risk factors compound

Don’t test: - Won’t change acute management - Test during anticoagulation-free period if needed

19.9.3 No VTE but Family History/Thrombophilia

Consider testing if: - Family history strong (multiple relatives, young VTE) - Planning pregnancy w/ thrombophilia - Starting estrogen (CHC/HRT)

AT/PC/PS deficiency: - Favorable risk-benefit pregnancy planning - Antithrombin highest risk

FVL/PGM heterozygous: - Weak risk; recommend against testing

19.9.4 Estrogen-Based Risk Factors (CHC/HRT)

Testing: - May identify candidates for non-estrogen alternatives - Limited value: most heterozygous mutations compatible w/ CHCs - Shared decision-making about alternative contraceptives

Clinical Pearl: Thrombophilia w/ Estrogen

Testing inaccurate during acute VTE, heparin, DOACs, warfarin, pregnancy, liver disease, chemotherapy. Evaluate timing before interpretation.

19.10 Bibliography

ASH VTE guidelines Bacon S, Kirtesplatz S, Middledorp S, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: venous thromboembolism in the context of pregnancy. Blood Adv. 2023;7(12):7101-7138.

Middledorp S, Nieusstat, R, Bäumun Kreuziger L, et al. American Society of Hematology 2021 guidelines for management of venous thromboembolism: hematologic testing. Blood Adv. 2023;7(12):7101-7138.

Other society guidelines Ascherlaje DJ, Michalski DS, Chandrahasa A, et al. (2023). Thrombophilia testing: a British Society for Haematology guideline. Br J Haematol. 1980;133:450.

McConnell T, Harriings MC, Horney JS, Keeley S. Guideline committee: Venous thromboembolism in adults: clinical guidance on diagnosis, management, & thrombophilia testing. BMJ. 2020;Sep 985.

Pathophysiology of thrombophilia Makker RA. Laboratory evaluation of thrombophilia. Methods Mol Biol. 2023;2684:177-201.

Patrono D, Cormes VM, Musarella S, et al. A comprehensive review of risk factors for venous thromboembolism: first epidemiology to pathophysiology. Rev J Med Sci. 2023;326(4):369-389.

Thrombophilia assays Amnis J, Heileisen P. Thrombophilia testing—a systematic review. Clin Lab. 2023;69(6):250-715.

Hannington B, Hart C. Laboratory diagnostics in thrombophilia. Semin Hematol. 2023;60(2):97-110.

Makker R. A., et al. (2021). Recommendations for clinical laboratory testing for protein S deficiency: Communication from the SSC committee plasma coagulation inhibitors of the ISTH. J Thromb Haemost. 19(1):68-74.