Factor
V Leiden
Overview
Factor V Leiden (FAK-tur five LIDE-n) is a
mutation of one of the clotting factors in the blood. This mutation can
increase your chance of developing abnormal blood clots, most commonly in your
legs or lungs.
Most people with factor V Leiden never develop
abnormal clots. But in people who do, these abnormal clots can lead to
long-term health problems or become life-threatening.
Both men and women can have factor V Leiden.
Women who carry the factor V Leiden mutation may have an increased tendency to
develop blood clots during pregnancy or when taking the hormone estrogen.
If you have factor V Leiden and have developed
blood clots, anticoagulant medications can lessen your risk of developing
additional blood clots and help you avoid potentially serious complications.
Symptoms
The factor V Leiden mutation does not itself
cause any symptoms. Since factor V Leiden is a risk for developing blood clots
in the leg or lungs, the first indication that you have the disorder may be the
development of an abnormal blood clot.
Some clots do no damage and disappear on their
own. Others can be life-threatening. Symptoms of a blood clot depend on what
part of your body is affected.
A clot in a deep vein
This is known as deep vein thrombosis (DVT),
which most commonly occurs in the legs. A DVT may not cause any symptoms. If
signs and symptoms do occur, they can include:
·
Pain
·
Swelling
·
Redness
·
Warmth
A clot that travels to
your lungs
Known as a pulmonary embolism, this occurs
when a portion of a DVT breaks free and travels through the right side of your
heart to your lung, where it blocks blood flow. This can be a life-threatening
situation. Signs and symptoms may include:
·
Sudden shortness of
breath
·
Chest pain when
breathing in
·
A cough that produces bloody
or blood-streaked sputum
·
Rapid heartbeat
When to see a doctor
Seek medical attention immediately if you have
signs or symptoms of either a DVT or a pulmonary embolism.
Causes
If you have factor V Leiden, you inherited
either one copy or, rarely, two copies of the defective gene. Inheriting one
copy slightly increases your risk of developing blood clots. Inheriting two
copies — one from each parent — significantly increases your risk of developing
blood clots.
Risk factors
A family history of factor V Leiden increases
your risk of inheriting the disorder. The disorder is most common in people who
are white and of European descent.
People who have inherited factor V Leiden from
only one parent have a 5 percent chance of developing an abnormal blood clot by
age 65. Factors that increase this risk include:
·
Two
faulty genes. Inheriting the
genetic mutation from both parents instead of just one can significantly
increase your risk of abnormal blood clots.
·
Immobility. Extended periods of immobility, such as sitting
during a long airplane flight, can increase the risk of leg clots.
·
Estrogens. Oral contraceptives, hormone replacement
therapy and pregnancy can make you more likely to develop blood clots.
·
Surgeries
or injuries. Surgeries or
injuries such as broken bones can increase your risk of abnormal blood clots.
·
Non-O
blood type. Abnormal blood
clots are more common in people who have blood types of A, B or AB compared
with those with blood type O.
Complications
Factor V Leiden can cause blood clots in the
legs (deep vein thrombosis) and lungs (pulmonary embolism). These blood clots
can be life-threatening.
Diagnosis
Your doctor may suspect factor V Leiden if
you've had one or more episodes of abnormal blood clotting or if you have a
strong family history of abnormal blood clots. Your doctor can confirm that you
have factor V Leiden with a blood test.
Treatment
Doctors generally prescribe blood-thinning
medications to treat people who develop abnormal blood clots. This type of
medicine usually isn't needed for people who have the factor V Leiden mutation
but who have not experienced abnormal blood clots.
However, your doctor might suggest that you
take extra precautions to prevent blood clots if you have the factor V Leiden
mutation and are going to have surgery. These precautions might include:
·
A short course of
blood thinners
·
Leg wraps that inflate
and deflate to keep blood moving in your legs
·
Compression stockings
·
Going for walks soon
after surgery
Lifestyle and home
remedies
Some precautions to help reduce your risk of
blood clots include:
·
Keep
your legs moving. When your legs
remain still for hours, your calf muscles don't contract, which normally helps
blood circulate. If you're on a long plane trip, raise your toes up and down
and rotate your ankles every hour or so. Drink extra water to prevent
dehydration, and avoid alcohol. On a car trip, take periodic breaks and walk
around.
·
Consider
compression stockings. These
types of socks, which usually come up to the knees, help improve blood
circulation in your legs. Ask your doctor if they might be a good option for
your situation.
·
Be
cautious with estrogen. Oral
contraceptives or estrogen replacement therapy can increase the risk of blood
clots on their own, so be sure to discuss the risks and the benefits of estrogen-containing
medications with your doctor if you have factor V Leiden.
Prevent excessive
bleeding
If your factor V Leiden requires you to take
anticoagulant medication, here are some steps that might help you prevent
injury and avoid excessive bleeding:
·
Avoid
playing contact sports or
engaging in other activities that could result in physical injury. Regular
noncontact exercise, such as walking or swimming, is still recommended for good
health.
·
Use
a soft toothbrush and waxed floss.
·
Avoid
shaving cuts by using an
electric razor.
·
Be
cautious with household tasks involving knives, scissors and other sharp tools.
Preparing for your
appointment
Your doctor may refer you to a specialist in
genetic disorders (geneticist) or a specialist in blood disorders (hematologist)
for testing to determine whether the cause of your blood clots is genetic and,
specifically, whether you have factor V Leiden.
Here's some information to help you prepare
for your appointment.
·
List
any symptoms you're experiencing, including any that may seem unrelated to the reason for
which you scheduled the appointment.
·
List
your health history, including your
history of blood clots. Include any family history of blood clots or known
family members with factor V Leiden.
·
Make
a list of all medications, vitamins
or supplements you're taking, along with the dose for each.
·
List
questions to ask your doctor.
For factor V Leiden, some basic questions to
ask your doctor include:
·
What kinds of tests do
I need?
·
Do I need to see a
specialist?
·
Does my factor V
Leiden need to be treated?
·
Do I need to take
medication to prevent additional blood clots?
·
What types of side
effects can I expect from the medication?
·
Do I need to limit my
activity in any way?
·
If I have children, do
they need to be tested?
·
Do you have any
brochures or other printed material that I can take with me? What websites do
you recommend?
If your doctor recommends genetic testing,
some questions you might want to ask the genetic specialist include:
·
How accurate is this
test?
·
What are the risks of
the test?
·
What information will
come out of the test?
·
What will a positive
or negative result tell me?
·
Can the results of the
test affect my ability to obtain health insurance?
·
Is an uncertain result
possible, and what would that mean?
·
What are my treatment
options if a mutation is found?
·
Could other family
members be affected?
·
Should my children be
tested?
·
What measures are in
place to protect my privacy?
·
How experienced is the
lab at performing this test?
·
How long will it take
to get results back?
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