I recently tested a patient, young 22 year old mother, at the time of a
repeat Rx for the OC, whose mother in turn had previously "had a DVT".
On fuller history it turned out mum (ie. grandma!) had a DVT at age 14 years
and another after birth of first child. Needless to say the daughter's $150
worth of Thrombophilia Tests were quite abnormal.
The test was useful in this case and we have explained that she should never
have the combined OC.
Addendum: We were advised in Auckland (NZ's largest haematology unit) the
following cost-contained protocol locally for considering "screening" for OC
users: (abbreviations below)
ATIII, PrC, PrS, APC (r), Lupus anticoag;
and APLAB indicated if...
(1) Previous proven VTE in patient
(2) Previous proven VTE in first degree relative
APC(r) should be done if...
suggestive hx of VTE in patient
suggestive hx of VTE in family member
Key:
APC(r) - APC resistance
ATIII = Antithrombin III
PrC = Protein C
PrS = Protein S
APLAB = Antiphospholipid antibody
Hope this is useful for somebody!
Dr Jon Wilcox
General Medicine, Paediatrics and Obstetrics,
Glenfield Medical Centre,
452 Glenfield Road,
Auckland 1310, New Zealand
Phone or Fax +649-444-7656
e-mail [log in to unmask]
-----Original Message-----
From: Adrian Midgley <[log in to unmask]>
To: @eurobell.net <@eurobell.net>
Cc: [log in to unmask] <[log in to unmask]>
Date: Wednesday, April 15, 1998 9:50 AM
Subject: Re: Leiden factor
>The Leiden variant of factor V is not a defficiency, indeed the factor
>is more effecttive at clotting.
>Too effective.
>
>THere is still some doubt over what the significance of Leiden V is and
>although it has been suggested that this genetic test should be applied
>to all women before starting the combined contraceptive pill* there is
>a dearth of evidence showing that it ould save trouble.
>
>In Exeter the test is not purchased.
>
>=======================
>
>* sometimes curously abbreviated COCP as though something other than
>oral was likely, or it came as other than Pills
>
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