HYPERCOAGULABILITY STATE

immobilisation:

prolonged bedrest (including post-MI and post-CVA)

prolonged air / road travel

postoperative state (especially abdo, hip, gynae, urological and lower limb operations)

drugs:

oral contraceptive pill

steroids

warfarin [may initially inhibit proteins C and S more than factors II, VII, IX and X; all are vit. K dependent]

haematological disorders:

hereditary:

factor V Leiden mutation [commonest of hereditary causes]

prothrombin G20210A mutation

antithrombin deficiency

factor XII deficiency

plasminogen deficiency

plasminogen activator deficiency

plasminogen activator inhibitor-1 deficiency

protein S deficiency

protein C deficiency

heparin cofactor II deficiency

sickle-cell disease

acquired:

disseminated intravascular coagulation

polycythaemia

essential thrombocythaemia

paroxysmal nocturnal haemoglobinuria

warm autoimmune haemolytic anaemia

other:

disseminated carcinoma

cardiac failure

obesity

dehydration

hyperosmolar nonketotic diabetic coma

nephrotic syndrome

severe trauma or burns

normal pregnancy and puerperal state

smoking

varicose veins

anticardiolipin antibodies ('lupus anticoagulant')

homocystinuria

Behçet's syndrome

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