Critical Care Medicine-Hematologic and Oncologic Disorders>>>>>Hypercoagulable States
Question 2#

Which of the following is LEAST likely to be a manifestation of factor V Leiden? 

A. Superficial vein thrombosis
B. Deep vein thrombosis (DVT)
C. Cerebral vein thrombosis
D. Arterial thrombosis

Correct Answer is D

Comment:

Correct Answer: D

Factor V Leiden is a mutated form of coagulation factor V that results in resistance to the anticoagulant effects of protein C. As a result, individuals with this factor V mutation are at increased risk for VTE. Heterozygosity for factor V Leiden is the most common inherited thrombophilia in Caucasian individuals with VTE. Factor V Leiden should be considered in a patient presenting with VTE at a young age, VTE in an unusual location (eg portal vein, cerebral vein), or recurrent VTE. Diagnosis can be made by DNA analysis or a functional coagulation test for activated protein C resistance. There is data associating factor V Leiden mutation with superficial vein thrombosis, pulmonary embolism, cerebral vein thrombosis (especially in women taking the oral contraceptive pill), and portal or hepatic vein thrombosis. Current data associating factor V Leiden mutation with arterial thromboembolism is weak, and the effect is small, if present.

References:

1. Dahlback B. Anticoagulant factor V and thrombosis risk (editorial). Blood. 2004;103:3995.
2. Cushman M, Rosendaal FR, Psaty BM, et al. Factor V Leiden is not a risk factor for arterial vascular disease in the elderly: results from the cardiovascular health study. Thromb Haemost. 1998;79:912.