Language
English
Publication Date
1-1-2023
Journal
Journal of Thrombosis and Haemostasis
DOI
10.1016/j.jtha.2022.10.014
PMID
36695379
Abstract
Activated protein C resistance (APC-R) due to the single-nucleotide polymorphism factor V Leiden (FVL) is the most common cause of hereditary thrombophilia. It is found predominantly in Caucasians and is uncommon or absent in other populations. Although FVL is responsible for >90% of cases of hereditary APC-R, a number of other F5 variants that also confer various degrees of APC-R and thrombotic risk have been described. Acquired APC-R due to increased levels of coagulation factors, reduced levels of inhibitors, or the presence of autoantibodies occurs in a variety of conditions and is an independent risk factor for thrombosis. It is common for thrombophilia screening protocols to restrict assessment for APC-R to demonstrating the presence or absence of FVL. The aim of this Scientific and Standardisation Committee communication is to detail the causes of FVL-independent APC-R to widen the diagnostic net, particularly in situations in which in vitro APC-R is encountered in the absence of FVL. Predilution clotting assays are not FVL specific and are used to detect clinically significant F5 variants conferring APC-R, whereas different forms of acquired APC-R are preferentially detected using the classical activated partial thromboplastin time-based APC-R assay without predilution and/or endogenous thrombin potential APC-R assays. Resource-specific recommendations are given to guide the detection of FVL-independent APC-R.
Keywords
Humans, Activated Protein C Resistance, Factor V, Thrombosis, Thrombophilia, Blood Coagulation, acquired, activated protein C resistance, coagulation assays, inherited, thrombosis
Published Open-Access
yes
Recommended Citation
Moore, Gary W; Castoldi, Elisabetta; Teruya, Jun; et al., "Factor V Leiden-Independent Activated Protein C Resistance: Communication From the Plasma Coagulation Inhibitors Subcommittee of the International Society on Thrombosis and Haemostasis Scientific and Standardisation Committee" (2023). Faculty and Staff Publications. 4250.
https://digitalcommons.library.tmc.edu/baylor_docs/4250