Antithrombin-3 Deficiency
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Coagulation
- Common Pathway of Coagulation
- Extrinsic Pathway of Coagulation
- Intrinsic Pathway of Coagulation
- Hemophilia A
- Hemophilia B
- Hemophilia C
- Factor V Leiden
- Antithrombin-3 Deficiency
Summary
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Key Points
- Antithrombin-3 Deficiency
- Pathogenesis
- Inherited deficiency of antithrombin-3
- Antithrombin 3 usually works to inhibit factors IIa and Xa
- Decreased inhibition of factors IIa and Xa → hypercoagulability
- May be acquired
- Renal failure or nephrotic syndrome
- Loss of antithrombin-3 in the urine
- Liver failure
- Inability to produce antithrombin-3 in the liver
- Renal failure or nephrotic syndrome
- Inherited deficiency of antithrombin-3
- Genetics
- Autosomal dominant inheritance
- Presentation
- Recurrent thrombosis (clots)
- Especially at a young age in otherwise healthy individual
- Venous > arterial
- DVT
- PE
- Recurrent thrombosis (clots)
- Diagnosis
- Normal PT, PTT, thrombin time
- No direct effect on secondary hemostasis as measured in the laboratory setting
- Diminished increase in PTT after heparin administration
- Normal PT, PTT, thrombin time
- Treatment
- Anticoagulants as needed for thrombosis
- Antithrombin replacement therapy
- Pathogenesis