Coagulation
Acquired thrombophilia / hypercoagulopathies
Acquired thrombophilia - general

Author: Jeremy Parsons, M.D. (see Authors page)

Revised: 28 April 2016, last major update April 2013

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed Search: Acquired thrombophilia [title]

General
  • Thrombophilia: any disorder associated with increased risk of venous thromboembolic disease; more appropriately called "hypercoagulable state" if not genetic, although terms often used interchangeably

  • Common risk factors are: antiphospholipid antibodies, chronic DIC, essential thrombocythemia, heparin induced thrombocytopenia, hyperhomocysteinemia, immobility, increasing age, malignancy, nephrotic syndrome, obesity, oral contraceptives, paroxysmal nocturnal hemoglobinuria, polycythemia vera, post-operative state, pregnancy, prior thromboembolism, systemic lupus erythematosus, trauma
  • Presence of more than one risk factor further increases risk (Arch Pathol Lab Med 2002;126:295)
Diagrams / Tables

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Initiation and propagation of blood coagulation

Activation of protein C by thrombin-thrombomodulin

Degradation of FVa and FVIIIa by APC

Blood coagulation and protein C anticoagulant system

Activation and degradation of normal FV and FV Leiden

20210G > A mutation in the prothrombin gene



Regulation of hemostasis

Balance of hemostasis

Genetic polymorphisms of various procoagulant proteins

Activated protein C (APC)

Transsulfuration pathway and metabolism of homocysteine

Case Reports
Clinical Images

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Thrombi in major trunks of pulmonary artery and large thrombus near left iliac vein.

Micro Images

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Fig. 1/2: old, recanalized thrombi in portal veins;
Fig. 3: recanalization of portal vein webs with intimal tags;
Fig. 4: bone marrow is hypercellular with large, dysplastic, abnormally clustered megakaryocytes