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Prothrombin G20210A

What's new

Added 2023 ASH, 2022 BSH, 2020 ESVS, 2020 ACG, and 2016 AF guidelines for the diagnosis and management of prothrombin G20210A.

Guidelines

Key sources

The following summarized guidelines for the evaluation and management of prothrombin G20210A are prepared by our editorial team based on guidelines from the American Society of Hematology (ASH 2023), the British Society for Haematology (BSH 2022), the American Association for the Study of Liver Diseases (AASLD 2021), the American Heart Association (AHA/ASA 2021,2011), the European Society for Vascular Surgery (ESVS ...
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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, portal vein thrombosis: as per ACG 2020 guidelines, consider initiating anticoagulation in patients with chronic portal vein thrombosis with evidence of inherited thrombophilia. Consider continuing anticoagulation indefinitely in patients with thrombophilia.
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  • Management of VTE (mesenteric vein thrombosis)

  • Management of VTE (cerebral vein thrombosis)

  • Management of AIS

Specific circumstances

Pregnant patients
As per SOGC 2014 guidelines:
Initiate prophylactic dose thromboprophylaxis during pregnancy in asymptomatic patients with homozygous prothrombin gene mutation 20210A.
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Administer pharmacologic thromboprophylaxis postpartum in patients with prothrombin gene mutation 20210A.
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