A Positive Test for Hypercoagulability

Differential Diagnosis

Presence of factor V Leiden (can be heterozygous or homozygous)

Presence of prothrombin 20210 mutation (can be heterozygous or homozygous)

Presence of antiphospholipid antibody; could be manifested as lupus anticoagulant or anticardiolipin antibodies or anti-beta 2 glycoprotein 1 antibodies (IgG, IgM, IgA)

Elevated homocysteine

Deficiency of protein C not produced by Coumadin or other acquired cause

Deficiency of protein S not produced by Coumadin or other acquired cause

Deficiency of antithrombin not produced by heparin or low-molecular-weight heparin therapy or other acquired cause

Suggested Additional Lab Testing

Test for activated protein C resistance as a screening test for factor V Leiden mutation.

If screening test suggests a heterozygous or homozygous form of factor V Leiden mutation, perform a genetic test to determine zygosity.

If lupus anticoagulant is present, the activated protein C resistance test will suffer interference; only the genetic test for factor V Leiden should be performed in this circumstance.

Perform genetic test for prothrombin 20210 mutation; there is no simple screening test for this abnormality.

Test for antiphospholipid antibody, both for lupus anticoagulant and anticardiolipin antibodies, and/or anti-beta 2 glycoprotein 1 antibodies (IgG and IgM at least).

Test for protein C functional activity; if the functional activity is low, test for protein C antigen to reveal type of protein C deficiency.

Test for protein S either by functional assay or free antigen assay; if there is a deficiency, measure total protein S antigen to type a congenitally low protein S patientt. Test for antithrombin functional activity; if it is low in absence of heparin, measure antithrombin antigenic activity to type the deficiency.

Related Resources

You must be a registered member of Cancer Therapy Advisor to post a comment.

Sign Up for Free e-newsletters

Regimen and Drug Listings


Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Prostate Cancer Regimens Drugs
Rare Cancers Regimens
Renal Cell Carcinoma Regimens Drugs
Skin Cancer Regimens Drugs
Urologic Cancers Regimens Drugs