What does thrombophilia screening test for?
Feb 22, 2022
Source: Cainiu Health
Dr. Yin Hongmei
Introduction
Under normal circumstances, based on the aforementioned indicators, one can determine whether an individual is predisposed to thrombotic disorders or possesses a thrombophilic constitution. These indicators include assessments of abnormal coagulation and bleeding times, as well as evaluation of platelet function—both of which are components of thrombophilia screening tests.
Thrombophilia refers to an increased predisposition to thromboembolism due to inherited or acquired deficiencies in anticoagulant proteins (e.g., antithrombin III, protein C, protein S), coagulation factors, or fibrinolytic proteins—or due to the presence of acquired risk factors.
What does thrombophilia screening assess?
Thrombophilia screening primarily evaluates antithrombin III, protein C, and protein S levels. Occasionally, additional parameters may be tested, but these three constitute the core panel.
Under routine clinical conditions, results from these tests help determine whether an individual has a heightened susceptibility to thromboembolic disease—i.e., whether they possess a thrombophilic constitution. Screening also includes assessment of coagulation and bleeding times, as well as evaluation of platelet function, all of which fall within the scope of thrombophilia testing.
Thrombophilia denotes an elevated risk of thromboembolism resulting from inherited or acquired (including immune-mediated) defects in anticoagulant proteins, coagulation factors, or fibrinolytic proteins. Patients with thrombophilia are prone to developing deep vein thrombosis (DVT) and pulmonary embolism (PE), collectively termed venous thromboembolism (VTE). The predominant thromboembolic manifestation in thrombophilia is VTE. Treatment primarily involves oral or intravenous anticoagulant therapy—for example, warfarin sodium tablets or enteric-coated aspirin tablets. Warfarin sodium is currently the most commonly used anticoagulant; when administered, the international normalized ratio (INR) of prothrombin time should be maintained within the therapeutic range of 2.0–3.0.
CT imaging can accurately differentiate acute from chronic thrombi, thereby aiding clinicians in formulating appropriate treatment strategies. CT angiography (CTA) findings often allow estimation of thrombus age. In acute PE, CT pulmonary angiography (CTPA) typically reveals intraluminal filling defects within the pulmonary arteries, partial or complete vascular occlusion, and arterial dilatation. A highly specific sign is an acute-angle interface between the filling defect and the vessel wall.
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