{"id":1969,"date":"2020-05-08T07:16:54","date_gmt":"2020-05-08T07:16:54","guid":{"rendered":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/?page_id=1969"},"modified":"2022-09-01T14:25:51","modified_gmt":"2022-09-01T02:25:51","slug":"thrombophilia-test-request-protocol","status":"publish","type":"page","link":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/for-referrers\/requesting-tests\/thrombophilia-test-request-protocol\/","title":{"rendered":"Thrombophilia test request protocol"},"content":{"rendered":"\n<p><strong><em>Introduced May 2011<\/em><\/strong><em><strong>, updated September 2022<\/strong><\/em><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Who should have Thrombophilia Screening?<\/strong><\/h2>\n\n\n\n<p>Thrombophilia screening may be of value in the following groups:<\/p>\n\n\n\n<ul><li>Patients with a venous thrombosis at an early age (&lt;45) who also have a strong first-degree family history (one or more family members) of proven thrombosis<\/li><li>Patients with a venous thrombosis at any age who have a strong first-degree family history (one or more family members) of unprovoked venous thrombosis.<\/li><li>Patients with an unprovoked venous thrombosis at an early age (&lt;45) with no family history should also be tested for antiphospholipid antibodies and lupus anticoagulant.<\/li><li>Adults with skin necrosis in association with vitamin K antagonists, such as warfarin, should be tested for Protein C and Protein S deficiency once vitamin K antagonists have been withdrawn.<\/li><li>Neonates and Children with Purpura Fulminans should be tested urgently for Protein C and Protein S deficiency and discussed with Haematology Consultant as further specialist assays may be needed.<\/li><li>Case finding of asymptomatic relatives with high risk thrombophilia such as Antithrombin, Protein C and Protein S deficiency should only be considered in selected thrombosis prone families and only after the risks, benefits and limitations of testing have been discussed.<\/li><li>Individuals with arterial thrombosis at a young age (&lt;40) should be tested for acquired conditions such as antiphospholipid antibodies and lupus anticoagulant, and screening for myeloproliferative disorders should be considered<\/li><li>Thrombosis in unusual sites (e.g. cerebral, mesenteric, portal &#8211; does NOT include retinal vein, upper limb or catheter-related VTE). Also consider screening for acquired myeloproliferative neoplasms in patients with portal or hepatic vein thrombosis as the prevalence of these conditions is high in this subgroup.<\/li><li>Women with a history of recurrent miscarriage, pre-eclampsia intrauterine growth retardation eclampsia before 34 weeks of pregnancy or intrauterine death should be screened for the presence of antiphospholipid antibodies and lupus anticoagulant.<\/li><\/ul>\n\n\n\n<p class=\"has-text-align-center\"><strong><em>In all other situations testing should only be undertaken after consultation with a Haematologist or as part of a clinical trial.<\/em><\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Testing is not indicated in the following<\/h2>\n\n\n\n<ul><li>Case finding of asymptomatic relatives for the Factor V Leiden or Prothrombin Gene Mutations is not recommended.<\/li><li>Thrombophilia screening should not be performed in asymptomatic patients considering use of oestrogen-based contraception. If these patients have a strong first-degree family history of thrombosis (one more family members), then alternative contraception (eg. Progesterone only pill, Progesterone depot injection \/ implant, intrauterine contraceptive devices) should be considered.<\/li><li>Thrombophilia screening should not be performed in asymptomatic patients considering use of HRT. If these patients have a strong first-degree family history of thrombosis (one or more family members), then use of transdermal HRT should be considered as this represents a lower thrombotic risk.<\/li><li>Thrombophilia screening should not be performed in asymptomatic patients planning pregnancy. If these patients have a strong first-degree family history of thrombosis (one or more family members) it may be appropriate to consider 6 weeks of post-partum thromboprophylaxis but this decision should be made on clinical grounds alone.<\/li><li>Women who have suffered a VTE in a previous pregnancy or with use of oestrogen-based contraception may be given thromboprophylaxis in a subsequent pregnancy. This decision should be made on clinical grounds alone.<\/li><li>Patients with central venous catheter related venous thrombosis or retinal vein occlusion<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Timing of testing<\/h2>\n\n\n\n<ul><li>Screening at the time of acute thromboembolism is not indicated as the results are often misleading and will not influence initial management<\/li><li>Thrombophilia screens should not be requested in patients on anticoagulants as both warfarin and heparin (and novel anticoagulants) may interfere with many of the tests.<\/li><li>Thrombophilia screens should be performed once the patient has been off anticoagulant therapy for a least 3 weeks.<\/li><li>Diagnosis of Antithrombin, Protein C or Protein S deficiency should not be made on a single abnormal result as a single test result may not be reliable.<\/li><li>Pregnancy can influence the results of screening, therefore screening should be performed in the non-pregnant state.<\/li><li>Where testing is indicated it is preferable for this to be done through the Thrombophilia Clinic to ensure that the correct tests are done including any necessary further specialist<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Further information<\/h2>\n\n\n\n<p>A comment will appear on the test report when thrombophilia testing is not performed.<\/p>\n\n\n\n<p>For thrombophilia testing requests beyond the clinical indications on this page please consult with a haematologist at Wellington SCL or Wellington Public Hospital.<\/p>\n","protected":false},"excerpt":{"rendered":"Introduced May 2011, updated September 2022 Who should have Thrombophilia Screening? Thrombophilia screening may be of value in the following groups: Patients with a venous thrombosis at an early age (&lt;45) who also have a strong first-degree family history (one or more family members) of proven thrombosisPatients with a venous thrombosis at any age who [&hellip;]","protected":false},"author":1,"featured_media":0,"parent":546,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-left-sidebar.php","meta":{"footnotes":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.2 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Thrombophilia test request protocol &#8211; Awanui Labs - Wellington<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/for-referrers\/requesting-tests\/thrombophilia-test-request-protocol\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Thrombophilia test request protocol &#8211; Awanui Labs - Wellington\" \/>\n<meta property=\"og:description\" content=\"Introduced May 2011, updated September 2022 Who should have Thrombophilia Screening? Thrombophilia screening may be of value in the following groups: Patients with a venous thrombosis at an early age (&lt;45) who also have a strong first-degree family history (one or more family members) of proven thrombosisPatients with a venous thrombosis at any age who [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/for-referrers\/requesting-tests\/thrombophilia-test-request-protocol\/\" \/>\n<meta property=\"og:site_name\" content=\"Awanui Labs - Wellington\" \/>\n<meta property=\"article:modified_time\" content=\"2022-09-01T02:25:51+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/fl-healthscope-media.s3.amazonaws.com\/lab-sites\/uploads\/sites\/3\/2023\/08\/Awanui-Labs-Lab-Technician-min.jpeg\" \/>\n\t<meta property=\"og:image:width\" content=\"2000\" \/>\n\t<meta property=\"og:image:height\" content=\"917\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/for-referrers\/requesting-tests\/thrombophilia-test-request-protocol\/\",\"url\":\"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/for-referrers\/requesting-tests\/thrombophilia-test-request-protocol\/\",\"name\":\"Thrombophilia test request protocol &#8211; Awanui Labs - Wellington\",\"isPartOf\":{\"@id\":\"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/#website\"},\"datePublished\":\"2020-05-08T07:16:54+00:00\",\"dateModified\":\"2022-09-01T02:25:51+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/for-referrers\/requesting-tests\/thrombophilia-test-request-protocol\/#breadcrumb\"},\"inLanguage\":\"en-NZ\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/for-referrers\/requesting-tests\/thrombophilia-test-request-protocol\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/for-referrers\/requesting-tests\/thrombophilia-test-request-protocol\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"For Referrers\",\"item\":\"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/for-referrers\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Requesting Tests\",\"item\":\"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/for-referrers\/requesting-tests\/\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Thrombophilia test request protocol\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/#website\",\"url\":\"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/\",\"name\":\"Awanui Labs - Wellington\",\"description\":\"Laboratory and pathology services\",\"publisher\":{\"@id\":\"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-NZ\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/#organization\",\"name\":\"Awanui Labs - Wellington\",\"url\":\"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-NZ\",\"@id\":\"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/fl-healthscope-media.s3.amazonaws.com\/lab-sites\/uploads\/sites\/3\/2023\/08\/RGB_Awanui-Labs-horizonal-colour-positive.svg\",\"contentUrl\":\"https:\/\/fl-healthscope-media.s3.amazonaws.com\/lab-sites\/uploads\/sites\/3\/2023\/08\/RGB_Awanui-Labs-horizonal-colour-positive.svg\",\"width\":861,\"height\":133,\"caption\":\"Awanui Labs - Wellington\"},\"image\":{\"@id\":\"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/#\/schema\/logo\/image\/\"}}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Thrombophilia test request protocol &#8211; Awanui Labs - Wellington","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/for-referrers\/requesting-tests\/thrombophilia-test-request-protocol\/","og_locale":"en_US","og_type":"article","og_title":"Thrombophilia test request protocol &#8211; Awanui Labs - Wellington","og_description":"Introduced May 2011, updated September 2022 Who should have Thrombophilia Screening? Thrombophilia screening may be of value in the following groups: Patients with a venous thrombosis at an early age (&lt;45) who also have a strong first-degree family history (one or more family members) of proven thrombosisPatients with a venous thrombosis at any age who [&hellip;]","og_url":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/for-referrers\/requesting-tests\/thrombophilia-test-request-protocol\/","og_site_name":"Awanui Labs - Wellington","article_modified_time":"2022-09-01T02:25:51+00:00","og_image":[{"width":2000,"height":917,"url":"https:\/\/fl-healthscope-media.s3.amazonaws.com\/lab-sites\/uploads\/sites\/3\/2023\/08\/Awanui-Labs-Lab-Technician-min.jpeg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","twitter_misc":{"Est. reading time":"4 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/for-referrers\/requesting-tests\/thrombophilia-test-request-protocol\/","url":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/for-referrers\/requesting-tests\/thrombophilia-test-request-protocol\/","name":"Thrombophilia test request protocol &#8211; Awanui Labs - Wellington","isPartOf":{"@id":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/#website"},"datePublished":"2020-05-08T07:16:54+00:00","dateModified":"2022-09-01T02:25:51+00:00","breadcrumb":{"@id":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/for-referrers\/requesting-tests\/thrombophilia-test-request-protocol\/#breadcrumb"},"inLanguage":"en-NZ","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.awanuilabs.co.nz\/central\/wellington\/for-referrers\/requesting-tests\/thrombophilia-test-request-protocol\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/for-referrers\/requesting-tests\/thrombophilia-test-request-protocol\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/"},{"@type":"ListItem","position":2,"name":"For Referrers","item":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/for-referrers\/"},{"@type":"ListItem","position":3,"name":"Requesting Tests","item":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/for-referrers\/requesting-tests\/"},{"@type":"ListItem","position":4,"name":"Thrombophilia test request protocol"}]},{"@type":"WebSite","@id":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/#website","url":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/","name":"Awanui Labs - Wellington","description":"Laboratory and pathology services","publisher":{"@id":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-NZ"},{"@type":"Organization","@id":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/#organization","name":"Awanui Labs - Wellington","url":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/","logo":{"@type":"ImageObject","inLanguage":"en-NZ","@id":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/#\/schema\/logo\/image\/","url":"https:\/\/fl-healthscope-media.s3.amazonaws.com\/lab-sites\/uploads\/sites\/3\/2023\/08\/RGB_Awanui-Labs-horizonal-colour-positive.svg","contentUrl":"https:\/\/fl-healthscope-media.s3.amazonaws.com\/lab-sites\/uploads\/sites\/3\/2023\/08\/RGB_Awanui-Labs-horizonal-colour-positive.svg","width":861,"height":133,"caption":"Awanui Labs - Wellington"},"image":{"@id":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/#\/schema\/logo\/image\/"}}]}},"featured_image_src":null,"featured_image_src_square":null,"_links":{"self":[{"href":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/wp-json\/wp\/v2\/pages\/1969"}],"collection":[{"href":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/wp-json\/wp\/v2\/comments?post=1969"}],"version-history":[{"count":6,"href":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/wp-json\/wp\/v2\/pages\/1969\/revisions"}],"predecessor-version":[{"id":5018,"href":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/wp-json\/wp\/v2\/pages\/1969\/revisions\/5018"}],"up":[{"embeddable":true,"href":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/wp-json\/wp\/v2\/pages\/546"}],"wp:attachment":[{"href":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/wp-json\/wp\/v2\/media?parent=1969"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}