Rule out genetic hypercoagulability: May need long term anticoagulation like Warfarin.
Panel of labs to order:
- Antiphospholipid Antibody screening panel: Anti-Cardiolipin IgA,G,M.
- Only hypercoagulable state that causes thrombosis in both VEIN and ARTERY!
- Antinuclear Antibody (ANA) w/ reflex
- Recurrent pregnancy loss.
- CPK (CK) – Screening for Connective Tissue Disorder in general:
- Factor V Leiden mutation
- Protein C&S – outpatient
- Patients with a history of Warfarin-induced skin necrosis are at increased risk of Protein C deficiency (rarely Protein S deficiency or Factor V Leiden).
- Rheumatoid Factor antibody titer
- Antithrombin III – outpatient
- Prothrombin 20210A
- Beta 2-glycoprotein Ab
- Lupus anticoagulase
- Others: Homocysteine, folic acid, Vitamin B12, peripheral smear, ESR, FOBT, chest x-ray
- OUTpatient: Protein S, Protein C, Antithrombin III, Colonoscopy.