Pathology - ​Factor V Leiden Thrombophilia

Pathology - ​Factor V Leiden Thrombophilia
Deep venous thrombosis (DVT) in left femoral vein may arise due to factor V Leiden thrombophilia. It is an autosomal dominant inherited disease and the most common hereditary hypercoagulability illness.
Family history will likely be positive for venous thromboembolic events (DVT or pulmonary embolism). The condition is a result of mutant clotting factor V that is unable to be destroyed by protein C. Uninhibited factor V activity promotes thrombin production, leading to excess fibrin and excessive coagulation. Patients will likely not have risk factors normally associated with venous thromboembolism, such as prolonged stasis (e.g., recent surgery, long flights, sedentary jobs), hypercoagulability (e.g., malignancy, oral contraceptives, pregnancy), or injury to vasculature (e.g., age, trauma, smoking). The most typical area for clots to form is in veins around the calf; however, advancement to femoral veins is often much more symptomatic. aPC would ordinarily contribute to prolonged coagulation times (aPTT) but will not have this effect in factor V Leiden people. Dilute Russell’s viper venom time may also be used to diagnose factor V Leiden.
Clinically, patients with DVT may suffer local soreness to palpation, pain with movement, erythema, warmth, and edema, which may be similar to cellulitis; however, patients with infection will often have a higher fever. Ultrasonography will often pinpoint the thrombus location.