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Annals of Vascular Surgery

, Volume 10, Issue 2, pp 174–177 | Cite as

Resistance to activated protein C: A common inherited cause of venous thrombosis

  • David L. Gillespie
  • Lee R. Carrington
  • John H. Griffin
  • Barbara M. Alving
Papers Presented At The Peripheral Vascular Surgery Society
  • 1 Downloads

Abstract

Resistance to activated protein C (RAPC) is a newly recognized hypercoagulable state that was first described in 1993. It has become apparent that RAPC is even more common than deficiencies in protein C, protein S, or antithrombin III (AT-III) and affects an estimated 5% of the general population. The majority of patients with RAPC have an abnormality in factor V (Arg506Gln), which renders factor Va resistant to degradation by activated protein C. Studies in 75 patients referred to the Hematology Laboratory at Walter Reed Army Institute of Research (WRAIR) over a 14-month period for evaluation of venous thromboembolism were reviewed to determine the percentage of those with RAPC. Of the 75 patients in the study, one was deficient in protein S, one was deficient in protein C, and none was deficient in AT-III. In contrast, 27 (36%) patients tested positive for RAPC. Blood was available for DNA analysis in 15 patients with RAPC. Of these 15 patients, nine (60%) tested positive for the Arg506Gln mutation in factor V. Six other patients with RAPC did not have the factor V mutation. Additional risk factors for thrombosis were immobility, obesity, use of oral contraceptives, and pregnancy. The majority of patients had deep venous thrombosis of the lower extremities; 71% had a recurrence if not placed on chronic anticoagulation therapy. Thus RAPC is a significant risk factor for venous thrombosis. Evaluation for inherited hypercoagulable states should include testing for this newly described condition.

Keywords

Oral Contraceptive Venous Thrombosis Deep Venous Thrombosis Significant Risk Factor Venous Thromboembolism 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Annals of Vascular Surgery Inc. 1996

Authors and Affiliations

  • David L. Gillespie
    • 1
    • 2
  • Lee R. Carrington
    • 1
    • 2
  • John H. Griffin
    • 1
    • 2
  • Barbara M. Alving
    • 1
    • 2
  1. 1.the Department of Hematology and Vascular Biology (B.M.A. and L.R.C.)Walter Reed Army Institute of ResearchWashington
  2. 2.The Scripps Research Institute (J.H.G.)La Jolla

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