Factor V Leiden testing is also just now available here and likewise I'm
wondering where I'll put it to use. It seems to me that we should be
testing those females who want to commence the OCP who also will have a
higher risk of PE/DVT: i.e., females who have a family history of PE/DVT;
females who smoke; and those who persistently demand 3rd generation
progestogin OCPs (not that there are many who can afford them here!).
Just my 2c/1p worth...
Regards, Dr Christopher Collins :)
On 21 Jul 1996 [log in to unmask] wrote:
> I do not know the place for this test, it seems at least possible that we
> should be doing it on every 12 year old girl along with the Rubella
> immunity test.
>
> What I am sure of is that whatever the place of this test - as an abstruse
> bit of haematology for the occasional person who has already had a PE, or
> else population screening test...
> It should not depend on whether your doctor is a fundholder.
>
> What are other areas doing about this?
>
> (12 because few girls go on the pill before that in Exeter - other areas
> mighta djust it)
> ------------
> Factor V Leiden
>
> Relative merits v thrombophilia screen
>
> Both aim to detect patient with an increased propensity for venous
> thrombosis.
> Factor V Leiden (FVL) accounts for approx 50% of cases of patients with
> young,
> recurrent, familial or unusual site venous thrombosis. It is found in 2-4% of
> the population. The thrombophilia screen tests Protein C, Protein S, anti
> thrombin III deficency, lupus anticoagulent and these account for 15% of high
> risk cases.
> Factor V Leiden can be looked for by a functional assay (activated protien C
> resistance APCR) which is part of the present thrombophilia screen at XXXX
> APCR is less sensitive and specific than the DNA test,and it can not be done
> on patients on warfarin, heparin or when a thrombosis is first detected. FVL
> is
> a similar price to activated protien C resistance and is 25% of the cost of a
> thrombophila screen.
> In summary the most important cause of thrombophilia is facotr V Leiden which
> results in a 7 fold increase in venous thrombosis and affects 2-4% of the
> population. It is not performed in the XXXX because of lack of purchaser
> funding.
> Thrombophila screening which is much more expensive is performed (with
> a poor substitute functional test) because it is already purchased. Dr XXX
> is
> very keen to use FVL as the first line test in all patients being
> investigated
> for thrombophilia but can not transfer money out of haematology. Any support
> to provide this test for appropriate high risk patients at a level of 500
> cases/year at UKP16 ie UKP8,000/year would be greatly appreciated. At
> present
> only fundholders can have this test. Thanks
> XXXXXXXXXX XXXXXXXXXXXXXXXX
>
>
>
>
>
>
>
>
>
>
>
> --- OffRoad 1.9n registered to Adrian Midgley
>
> ----------------------
> Dr Adrian Midgley GP Exeter
> [log in to unmask]
> Fax 01392-436105
> ----------------------
>
>
Dr Christopher T.G. Collins M.B.,B.S. F.R.A.C.G.P.
General Practitioner/Family Physician
Caboolture 7 Day Medical Centre
King St, Caboolture QLD 4510
AUSTRALIA
Information Technology Convenor
Brisbane North Division of General Practice
504 Lutwyche Rd, Windsor QLD 4057. AUSTRALIA
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