Hypercoagulability

Rule out genetic hypercoagulability: May need long term anticoagulation like Warfarin.

Panel of labs to order:

  1. 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.
  2. CPK (CK) – Screening for Connective Tissue Disorder in general:
  3. Factor V Leiden mutation
  4. Protein C&Soutpatient
    1. 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).
  5. Rheumatoid Factor antibody titer
  6. Antithrombin IIIoutpatient
  7. Prothrombin 20210A
  8. Beta 2-glycoprotein Ab
  9. Lupus anticoagulase
  10. Others: Homocysteine, folic acid, Vitamin B12, peripheral smear, ESR, FOBT, chest x-ray
  • OUTpatient: Protein S, Protein C, Antithrombin III, Colonoscopy.

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