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Factor V Leiden

Guidelines

Key sources

The following summarized guidelines for the evaluation and management of factor V Leiden are prepared by our editorial team based on guidelines from the American Society of Hematology (ASH 2023,2018), the British Society for Haematology (BSH 2022), the American Association for the Study of Liver Diseases (AASLD 2021), the European Society for Vascular Surgery (ESVS 2021,2017), the International Federation of...
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Screening and diagnosis

Indications for screening, general principles: as per BSH 2022 guidelines, Do not obtain routine thrombophilia testing in first-degree relatives of patients with a history of VTE.
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  • Indications for screening (minor provoking risk factors)

  • Indications for screening (before combined oral contraceptives)

  • Indications for screening (before hormonal therapy)

  • Indications for screening (pregnancy)

  • Indications for testing (first episode of thrombosis)

  • Indications for testing (DVT)

  • Indications for testing (cerebral vein thrombosis)

  • Indications for testing (mesenteric vein thrombosis)

  • Indications for testing (portal vein thrombosis)

  • Indications for testing (Budd-Chiari syndrome)

  • Indications for testing (superficial vein thrombosis)

  • Indications for testing (unusual site venous thrombosis)

  • Indications for testing (recurrent thrombosis)

  • Indications for testing (arterial thrombosis)

Medical management

Management of VTE, general principles: as per Pathway 2023 guidelines, Manage VTE in FVL mutation carriers according to current published guidelines on VTE (including DVT, PE, cerebral venous thrombosis, as well as thrombosis in unusual sites).
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  • Management of VTE (DVT)

  • Management of VTE (cerebral vein thrombosis)

  • Management of VTE (mesenteric vein thrombosis)

  • Management of VTE (portal vein thrombosis)

Specific circumstances

Pregnant patients, screening: as per BSH 2022 guidelines, Do not obtain screening for heritable thrombophilias in patients with pregnancy complications, such as recurrent miscarriage or adverse pregnancy outcomes.
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  • Pregnant patients (antepartum)

  • Pregnant patients (postpartum)