Thrombophilia: How To Test? How To Manage?

By Julie Hambleton, MD

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Secondary Causes

Secondary causes of thrombophilia (Table 1) are important to recognize and may be modifiable. Oral contraceptive agents or hormone replacement therapy, high-risk surgery, obesity, and the presence of a central venous catheter are potentially reversible risk factors for VTE and, if modified, will lower the patient's likelihood of recurrent VTE. Cancer, with or without evidence of disseminated intravascular coagulation (DIC), paroxysmal nocturnal hemoglobinuria, and the lupus anticoagulant are likely to be persistent risk factors associated with a significant risk of recurrent VTE.

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