Factor V Leiden

Aka: Factor V Leiden, Factor 5 Leiden, Activated Protein C resistance, APC Resistance

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II. Epidemiology

  1. Responsible for 20-50% of Hypercoagulable patients
  2. Incidence of Autosomal Dominant genetic defect
    1. Europeans: 15%
    2. North America: 3-5%

III. Risks

  1. Heterozygote: 5-10 times the risk of thrombosis
  2. Homozygote: 50-100 times the risk of thrombosis

IV. Pathophysiology

  1. Factor V is a Cofactor for Factor X
  2. Defect prevents Factor V degradation by Protein C

V. Labs

  1. Activated Protein C (APC) resistance
    1. Can not be anticoagulated when this lab run
  2. PCR for Factor V Leiden
    1. Responsible for 95% of APC Resistance
    2. Does NOT require that patient be off Anticoagulation

VI. Complications

  1. Deep Vein Thrombosis
  2. Pulmonary Embolism
  3. Myocardial Infarction

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