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Thrombophilia Screening and Ischemic Stroke

Thrombophilia Screening and Ischemic Stroke In their review of patent foramen ovale in cryptogenic stroke, Wu et al1 include factor V Leiden, prothrombin 20210 mutation, proteins C and S deficiency, and antithrombin III deficiency among the thrombophilic abnormalities causing and predisposing to stroke and transient ischemic attack and recommend screening younger individuals presenting with stroke. In contrast to the association between antiphospholipid antibodies and lupus anticoagulants and arterial thrombosis, these inherited thrombophilic abnormalities have been shown not to be significantly linked with stroke or transient ischemic attack.2 The high prevalence of these abnormalities makes the probability of a coincidental finding high. Although factor V Leiden and prothrombin 20210 mutation may play a small role in a subtype of stroke,3 their inclusion in the routine investigation of ischemic stroke is not recommended by current guidelines.4 Correspondence: Dr Butler, Department of Haematology, Falkirk Royal Infirmary, Major’s Loan, Falkirk FK1 5QE, Scotland (andrew.butler@fvah.scot.nhs.uk). References 1. Wu LAMalouf JFDearani JA et al. Patent foramen ovale in cryptogenic stroke: current understanding and management options. Arch Intern Med 2004;164950- 956PubMedGoogle ScholarCrossref 2. Karttunen VHiltunen LRasi V et al. Factor V Leiden and prothrombin gene mutation may predispose to paradoxical embolism in subjects with patent foramen ovale. Blood Coagul Fibrinolysis 2003;14261- 268PubMedGoogle Scholar 3. Walker IDGreaves MPreston FE et al. Investigation and management of heritable thrombophilia. Br J Haematol 2001;114512- 528PubMedGoogle ScholarCrossref 4. Hankey GJEikelboom JWvan Bockxmeer FM et al. Inherited thrombophilia in ischemic stroke and its pathogenic subtypes. Stroke 2001;321793- 1799PubMedGoogle ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Thrombophilia Screening and Ischemic Stroke

Archives of Internal Medicine , Volume 164 (22) – Dec 13, 2004

Thrombophilia Screening and Ischemic Stroke

Abstract

In their review of patent foramen ovale in cryptogenic stroke, Wu et al1 include factor V Leiden, prothrombin 20210 mutation, proteins C and S deficiency, and antithrombin III deficiency among the thrombophilic abnormalities causing and predisposing to stroke and transient ischemic attack and recommend screening younger individuals presenting with stroke. In contrast to the association between antiphospholipid antibodies and lupus anticoagulants and arterial thrombosis, these inherited...
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References (4)

Publisher
American Medical Association
Copyright
Copyright © 2004 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.164.22.2502-a
Publisher site
See Article on Publisher Site

Abstract

In their review of patent foramen ovale in cryptogenic stroke, Wu et al1 include factor V Leiden, prothrombin 20210 mutation, proteins C and S deficiency, and antithrombin III deficiency among the thrombophilic abnormalities causing and predisposing to stroke and transient ischemic attack and recommend screening younger individuals presenting with stroke. In contrast to the association between antiphospholipid antibodies and lupus anticoagulants and arterial thrombosis, these inherited thrombophilic abnormalities have been shown not to be significantly linked with stroke or transient ischemic attack.2 The high prevalence of these abnormalities makes the probability of a coincidental finding high. Although factor V Leiden and prothrombin 20210 mutation may play a small role in a subtype of stroke,3 their inclusion in the routine investigation of ischemic stroke is not recommended by current guidelines.4 Correspondence: Dr Butler, Department of Haematology, Falkirk Royal Infirmary, Major’s Loan, Falkirk FK1 5QE, Scotland (andrew.butler@fvah.scot.nhs.uk). References 1. Wu LAMalouf JFDearani JA et al. Patent foramen ovale in cryptogenic stroke: current understanding and management options. Arch Intern Med 2004;164950- 956PubMedGoogle ScholarCrossref 2. Karttunen VHiltunen LRasi V et al. Factor V Leiden and prothrombin gene mutation may predispose to paradoxical embolism in subjects with patent foramen ovale. Blood Coagul Fibrinolysis 2003;14261- 268PubMedGoogle Scholar 3. Walker IDGreaves MPreston FE et al. Investigation and management of heritable thrombophilia. Br J Haematol 2001;114512- 528PubMedGoogle ScholarCrossref 4. Hankey GJEikelboom JWvan Bockxmeer FM et al. Inherited thrombophilia in ischemic stroke and its pathogenic subtypes. Stroke 2001;321793- 1799PubMedGoogle ScholarCrossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Dec 13, 2004

Keywords: thrombophilia,ischemic stroke,screening

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