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Thromboembolic Disease – Causes

Causes

Many causes for the development of thromboembolic disease have been identified and these are typically divided into patient-related factors, trauma, disease states, surgical factors and hematological disorders. The risk of developing thromboembolic disease is additive.


Patient factors1

  • obesity
  • pregnancy
  • immobility
  • homocystinuria
     

Trauma2

  • pelvic surgery
  • hip fracture
  • long bone fracture
     

Disease states1,2

  • malignancy
  • congestive heart failure
  • atrial fibrillation
  • nephrotic syndrome
  • recent myocardial infarction (MI)
  • inflammatory bowel disease
  • spinal cord injury with paralysis
     

Surgery1–3

  • hip
  • knee
  • coronary artery bypass
  • urological
  • neurosurgery
  • splenectomy
     

Hematological disorders1,4–7

  • activated protein C-resistance (factor V Leiden)
  • antiphospholipid syndrome
  • protein C or protein S deficiency
  • antithrombin III deficiency
  • lupus anticoagulant
  • polycythemia vera
  • paroxysmal nocturnal hemoglobinuria
  • dysfibrinogenemia
  • sickle cell anemia


     

References

  1. Pearse DB. Chapter 22: Venous Thromboembolic Disease. The Johns Hopkins Internal Medicine Board Review. 2008;179–184.
  2. Scottish Intercollegiate Guidelines Network Guidelines on Prevention and Management of Venous Thromboembolism. 2010.
  3. Mohren M, Markmann I, Dworschak U, et al. Thromboembolic complications after splenectomy for hematologic diseases. Am J Hematol. 2004;76(2):143–147.
  4. Bugert P, Pabinger I, Stamer K, et al. The risk for thromboembolic disease in lupus anticoagulant patients due to pathways involving P-selectin and CD154. Thromb Hemost. 2007;97(4):573–580.
  5. Ambrus JL, Ambrus CM, Dembinsky W, et al. Thromboembolic disease susceptibility related to red cell membrane fluidity in patients with polycythemia vera and effect of phlebotomies. J Med. 1999;30(5-6):299–304.
  6. Ray JG, Burows RF, Ginsberg JS, Burrows EA. Paroxysmal nocturnal hemoglobinuria and the risk of venous thrombosis: review and recommendations for management of the pregnant and nonpregnant patient. Hemostasis. 2000;30(3):103-117.
  7. Morris TA, Marsh JJ, Chiles PG, et al. High prevalence of dysfibrinogenaemia among patients with chronic thromboembolic pulmonary hypertension. Blood. 2009;114(9): 1929-1936.