Which of the following is LEAST likely to be a manifestation of factor V Leiden?A. Superficial vein thrombosis
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.