Diagnosis of APC resistance during pregnancy

Cumming, A. M.; Tait, Robert C.; Fildes, S.; Hay, C. R. M.

doi:10.1111/j.1365-2141.1992.tb08264.x

Cited by 22 publications

(17 citation statements)

References 2 publications

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“…In fact, the modified test with a factor V depleted plasma is more specific for factor V mutation. Several studies have shown the existence of acquired APC resistance without fac tor V mutation during pregnancy (53,54). Similar results are obtained in women taking an estroprogestogen pill.…”

Section: Discussionsupporting

confidence: 76%

Diagnosis And Clinical Characteristics Of Inherited Activated Protein C Resistance

Samama

Simon²,

Mh³

et al. 1996

Pathophysiol Haemos Thromb

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The diagnostic strategies and clinical characteristics of thrombophilia associated with heterozygous or homozygous factor V Leiden mutation have been determined according to the literature and to a personal study in 51 families. Factor V mutation was present in the 51 propositi and in 84 out of 125 family members (81 heterozygous, 3 homozygous). Venous thrombosis was observed in all the propositi, in 17 of the 84 family members with the mutation and in 6 of the 41 with a normal APC resistance test and no mutation. An associated protein C or protein S deficiency was present in 5 families (10 %). The most frequent clinical manifestations were superficial or deep vein thrombosis and/or pulmonary embolism, but also thrombosis at an unusual site (cerebral, mesenteric or central retinal vein). A causal relationship is frequently difficult to demonstrate. A precipitating factor was observed in 84 % of cases and a recurrent thrombotic episode occured in 50 % of propositi. The risk of thrombosis associated with pregnancy was high in the post-partum period, especially in homozygous women. In the 28 homozygous subjects, markers of coagulation activation were frequently elevated in untreated patients. Finally, the efficacy of anticoagulant treatment is suggested but the long period often observed between treatment interruption and a recurrence does not militate in favour of long term treatment.

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Section: Discussionsupporting

confidence: 76%

Diagnosis And Clinical Characteristics Of Inherited Activated Protein C Resistance

Samama

Simon²,

Mh³

et al. 1996

Pathophysiol Haemos Thromb

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“…1994 ; Trossaert et al . 1994 ; Tosetto & Rodeghiero 1995), and it has been shown to allow reliable screening for pre‐existing APCR during pregnancy ( Cumming et al . 1996 ).…”

Section: Genetic Risk Factors For Thrombophiliamentioning

confidence: 99%

The investigation and management of inherited thrombophilia

Cumming

Shiach

1999

Clinical &Amp; Laboratory Haematology

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Inherited thrombophilia can be defined as a genetically determined tendency to venous thromboembolism. Genetic risk factors for venous thrombosis include antithrombin deficiency, protein C deficiency, protein S deficiency, activated protein C resistance due to the factor V gene Leiden mutation, inherited hyperhomocysteinaemia, elevated factor VIII levels and the prothrombin gene G20210 A variant. A genetic risk factor is now identifiable in up to 50% of unselected patients with venous thrombosis. Individuals with inherited thrombophilia may develop venous thrombosis at a young age, or they may present with thrombosis at an unusual site or in the apparent absence of any precipitating event. A family history of thrombosis is suggestive of inherited thrombophilia. Laboratory investigations for inherited thrombophilia should include testing for activated protein C resistance and the factor V gene Leiden mutation, and screening for deficiencies of antithrombin, protein C or protein S. Screening for the prothrombin gene G20210 A variant, and measurement of plasma factor VIII and homocysteine levels should be considered in individual cases. In recent years the multifactorial nature of thrombophilia, both circumstantially and on a genetic level, has become increasingly apparent. Individuals with more than one inherited thrombophilia risk factor are particularly prone to thrombosis and their identification is a priority.

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“…Some authors suggested that APC anticoagulant activity decreases significantly throughout pregnancy. Cumming et al [9] found APC-R in 42% of women at 14-20 weeks of gestation and 55% of women at 28 weeks of gestation. This temporary APC-R was not associated with the presence of the factor V gene Q506 (factor V Leiden) mutation, nor was it present in 'baseline' blood samples collected from the same individuals 18 weeks postpartum.…”

Section: Discussionmentioning

confidence: 99%

Activated Protein C Resistance in Turkish Women with Severe Preeclampsia

Çetın

Güçer²,

Serin³

et al. 2001

Gynecol Obstet Invest

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The purpose of this study was to investigate the occurrence rate of APC resistance (APC-R) with severe preeclampsia in Turkish women. Thirty-two consecutive women having severe preeclampsia were included in the study. Thirty-two healthy pregnant women served as the control group. APC-R assays were performed in the third trimester of pregnancy, and 3 and 9 months after delivery. APC-R was demonstrated in the third trimester, 3 months and 9 months after delivery in 27 (84.4%), 23 (71.9%) and 5 (15.6%) of 32 preeclamptic patients, respectively. APC-R rates were significantly higher in preeclamptic group than in normal pregnant women in the third trimester of pregnancy (p < 0.05). Decreased mean APC activity and also increased APC-R rate was still persisting in preeclamptic group for 3 months after delivery. Nine months after delivery, the mean APC activity and also APC-R rates approached to the normal pregnant women; however, there was a significant difference between both groups (p < 0.05). Our results indicate that acquired APC-R may be a contributory factor in the pathogenesis of preeclampsia.

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Diagnosis of APC resistance during pregnancy

Cited by 22 publications

References 2 publications

Diagnosis And Clinical Characteristics Of Inherited Activated Protein C Resistance

Diagnosis And Clinical Characteristics Of Inherited Activated Protein C Resistance

The investigation and management of inherited thrombophilia

Activated Protein C Resistance in Turkish Women with Severe Preeclampsia

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