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Topics:
Pediatric Hematology/Oncology • Medical Oncology • Internal Medicine • AYA • Hematology • Pediatric Hematology • Benign Hematology • Hemostasis/Thrombosis
Under what circumstances would you consider anticoagulation in a young female patient with persistently elevated factor XI activity?
While this is a known risk factor for venous [Meijers et al NEJM 2000] and potentially arterial [Yang et al, Am J Clin Pathol 2006] thrombosis, it is unclear to what extent this should affect the decision for anticoagulation.
Would this affect your decision for anticoagulation in a patient with prior venous thrombosis with transient risk factors? With history of stroke/CVA? During pregnancy/postpartum?
Answer from: at Academic Institution
First, get a baseline D-dimer to see how procoagulant she is at that point.
If elevated, long travel on plane, pre-op and post-op for 2 months - consider short-term anticoagulation.
If past thrombosis - give lifelong anticoagulation.
If pregnant - follow D-dimer; if it goes up, anticoagulate.
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