When you’re on anticoagulants, you may have concerns that you’re not quite sure about. Should you bother your doctor? My patients often bring up these concerns towards the end of a visit and start by saying, “Should I be worried, doctor?” It is essential to mention anything that bothers you rather than silently worrying. Some concerns are more important than others. In this … [Read more...]
Clots in Pregnancy – Symptoms
In my previous post about DVT in pregnancy I looked at the incidence of clots in Pregnancy. DVT is relatively rare but serious and should not be missed. The Royal College of Obstetricians and Gynaecologists guidelines quote that approximately 20% of DVTs can lead to a pulmonary emboli in pregnancy and these can be rapidly fatal. A suspected case of DVT should be … [Read more...]
Clots in pregnancy – How common?
Pregnancy Deep vein thrombosis and pulmonary embolus are serious complications of pregnancy. They are potentially life-threatening and can lead to long-term complications. Pulmonary embolus is the commonest cause of maternal death in most developed countries, so being aware of the risks and signs is very important. Increased risk of clotting Pregnancy is sometimes referred … [Read more...]
Risk factors: thrombophilia – Prothrombin 20210 mutation
The Prothrombin 20210 mutation is found in about 2% of Caucasian people and is very rare in other populations. It is regarded as a very minor risk factor for DVT or PE and only increases the risk of thrombosis about 2 fold. This is less than the risk of taking an oral contraceptive and is similar to the risk associated with smoking. In fact some people believe it is a normal … [Read more...]
Risk Factors: thrombophilia – Factor V Leiden
The factor V Leiden mutation is found in about 4% of Caucasian people; that is 1 in 25 people, which means you probably know somebody with this condition. Although it increases your risk of having a blood clot, the vast majority of people with this condition never have a clot. If 1 in 25 people had a blood clot I would be really busy! This mutation was discovered in Leiden … [Read more...]
Risk Factors: Thrombophilia – Protein S Deficiency
Protein S Protein S is another protein in the blood that works like a natural anticoagulant. It was discovered in Seattle, hence the name Protein S. Like Protein C and many of the clotting proteins it requires vitamin K for normal activity. It is present in the blood in two forms either bound to another protein called C4b-binding protein or as a free protein. Protein S works … [Read more...]
Risk Factors – Thrombophilia: Protein C deficiency
Protein C Protein C was discovered in the 1970s by Stenflo, a scientists working on plasma from cows. He was interested in the proteins that required vitamin K to function properly. He was doing an experiment separating vitamin K dependent proteins in bovine plasma using ion-exchange chromatography. During these experiments he found a protein not previously identified that … [Read more...]
Risk Factor – Thrombophilia: Antithrombin deficiency
Family History Since the first report, hundreds of families have been identified with antithrombin deficiency, but it is still quite a rare condition and only affects about 1 in 5000 people. It is found in about 2 to 3% of people who have a blood clot before the age of 40yrs. Research A great deal is now know about antithrombin. The DNA sequence is known and the molecular … [Read more...]
Risk Factors – Thrombophilia: Part 1
Over the last few months we have been running a series of posts on the risk factors for thrombosis. A few weeks ago I looked at the link between family history and thrombosis and touched on inherited causes of blood clots. This is a big field and quite complex as more and more risk factors have been identified. In this post I will give you some background to the … [Read more...]
The Story of Christmas Disease
Once upon a time in a land far away, in fact England in 1947, a boy called Stephen was born. While he was still a baby, his family took him to live in Canada where he soon started having problems with severe bleeding. At the age of 2 years he was diagnosed with haemophilia. On a visit back to England in 1952 at the age of 5yrs, Stephen unfortunately ended up back in hospital … [Read more...]