Document Detail

Resistance to activated protein C: a common inherited cause of venous thrombosis.
MedLine Citation:
PMID:  8733870     Owner:  NLM     Status:  MEDLINE    
Resistance to activated protein C (RAPC) is a newly recognized hypercoagulable state that was first described in 1993. It has become apparent that RAPC is even more common than deficiencies in protein C, protein S, or antithrombin III (AT-III) and affects an estimated 5% of the general population. The majority of patients with RAPC have an abnormality in factor V (Arg506Gln), which renders factor Va resistant to degradation by activated protein C. Studies in 75 patients referred to the Hematology Laboratory at Walter Reed Army Institute of Research (WRAIR) over a 14-month period for evaluation of venous thromboembolism were reviewed to determine the percentage of those with RAPC. Of the 75 patients in the study, one was deficient in protein S, one was deficient in protein C, and none was deficient in AT-III. In contrast, 27 (36%) patients tested positive for RAPC. Blood was available for DNA analysis in 15 patients with RAPC. Of these 15 patients, nine (60%) tested positive for the Arg506Gln mutation in factor V. Six other patients with RAPC did not have the factor V mutation. Additional risk factors for thrombosis were immobility, obesity, use of oral contraceptives, and pregnancy. The majority of patients had deep venous thrombosis of the lower extremities; 71% had a recurrence if not placed on chronic anticoagulation therapy. Thus RAPC is a significant risk factor for venous thrombosis. Evaluation for inherited hypercoagulable states should include testing for this newly described condition.
D L Gillespie; L R Carrington; J H Griffin; B M Alving
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Annals of vascular surgery     Volume:  10     ISSN:  0890-5096     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  1996 Mar 
Date Detail:
Created Date:  1996-10-10     Completed Date:  1996-10-10     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  174-7     Citation Subset:  IM    
Department of Vascular Surgery, Walter Reed Medical Center, Washington, DC 20307, USA.
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MeSH Terms
Anticoagulants / therapeutic use
Antithrombin III / physiology
Arginine / genetics
Contraceptives, Oral / adverse effects
DNA / analysis
Drug Resistance / genetics
Factor V / genetics*,  metabolism
Glutamine / genetics
Middle Aged
Mutation / genetics
Obesity / complications
Protein C / physiology*
Protein C Deficiency
Protein S Deficiency / diagnosis
Risk Factors
Thromboembolism / etiology,  genetics,  prevention & control
Thrombophlebitis / etiology*,  genetics,  prevention & control
Grant Support
Reg. No./Substance:
0/Anticoagulants; 0/Contraceptives, Oral; 0/Protein C; 0/factor V Leiden; 56-85-9/Glutamine; 74-79-3/Arginine; 9000-94-6/Antithrombin III; 9001-24-5/Factor V; 9007-49-2/DNA

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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