Acquired thrombophilias and preferred approach to diagnostic workup
| Acquired thrombophilia . | Workup . |
|---|---|
| Surgery, trauma, immobility, hospitalization, indwelling catheter, high estrogen state | History (transient/reversible risk factors) |
| Myeloproliferative neoplasm | Mutation analysis for JAK2, CALR, MPL |
| Malignancy, SLE/collagen vascular disease, nephrotic syndrome, inflammatory bowel disease, obesity | History/examination, basic laboratory tests (CBC, renal/ hepatic panels, urinalysis for protein), chest radiograph, age-appropriate cancer screening |
| Paroxysmal nocturnal hemoglobinuria | If suspected, CBC, haptoglobin, LDH, total/direct bilirubin, iron studies, urinalysis; peripheral blood flow cytometry |
| APLS | Revised Sapporo criteria (both required): clinical, vascular thrombosis and/or pregnancy morbidity; laboratory, 1 of the following on ≥2 occasions at least 12 weeks apart: IgG or IgM anti-cardiolipin antibodies (>40 U); IgG or IgM anti-β2-glycoprotein I antibodies (>40 U); LA |
| Acquired thrombophilia . | Workup . |
|---|---|
| Surgery, trauma, immobility, hospitalization, indwelling catheter, high estrogen state | History (transient/reversible risk factors) |
| Myeloproliferative neoplasm | Mutation analysis for JAK2, CALR, MPL |
| Malignancy, SLE/collagen vascular disease, nephrotic syndrome, inflammatory bowel disease, obesity | History/examination, basic laboratory tests (CBC, renal/ hepatic panels, urinalysis for protein), chest radiograph, age-appropriate cancer screening |
| Paroxysmal nocturnal hemoglobinuria | If suspected, CBC, haptoglobin, LDH, total/direct bilirubin, iron studies, urinalysis; peripheral blood flow cytometry |
| APLS | Revised Sapporo criteria (both required): clinical, vascular thrombosis and/or pregnancy morbidity; laboratory, 1 of the following on ≥2 occasions at least 12 weeks apart: IgG or IgM anti-cardiolipin antibodies (>40 U); IgG or IgM anti-β2-glycoprotein I antibodies (>40 U); LA |
CBC, complete blood count; LDH, lactate dehydrogenase; SLE, systemic lupus erythematosus.