Thrombophilia

In 1884, the outstanding German physician and physiologist Rudolf Virchow was the first to suggest that thrombosis is the result of at least one of the three basic factors or a combination of these:

• blood stasis in the veins of the lower extremities;
• increased ability of blood to thrombosis (thrombophilia);
• damage to the vessel wall.

Thus, thrombophilia was recognized as an important factor in the development of thrombosis.

The state of thrombophilia combines all hereditary and acquired disorders of hemostasis, which are characterized by a predisposition to the early appearance and recurrence of thrombosis, thromboembolism, ischemia, and organ infarction ^[4] . This condition can be inherited or associated with a disease (e.g., oncological), caused by taking medications (oral contraceptives, antitumor effects, etc.), or due to a state of health (e.g., pregnancy, limitation of mobility).
Here are the most common congenital disorders of hemostasis, causing a tendency to thrombosis:

• Antiphospholipid Syndrome
• Antithrombin deficiency
• Protein C deficiency
• Protein S Deficiency
• Factor V Leiden G1691A
• Mutation of the prothrombin gene G20210A
• Hyperhomocysteinemia
• MTGFR 677T

Concomitant risk factors leading to thrombophilia: surgical procedures in the area of ​​large venous arteries (operations on the hip joint, pelvic organs), other background types of pathology and conditions predisposing to venous thrombosis (malignant tumors, obesity, diabetes mellitus, heart failure, etc.) .d.). In addition, prolonged immobilization in both the pre- and postoperative period leads to a significant deterioration in venous hemodynamics ^[4] .
Pregnancy and the postpartum period are also accompanied by hypercoagulation associated with increased levels of procoagulant factors (increased levels of fibrinogen, factors V and VIII) and decreased anticoagulant activity (decreased protein S level and increased resistance of protein C activation) ^[5] .

The concept of “state of thrombotic readiness” combines laboratory detectable hypercoagulation according to the so-called “global” coagulogram tests ( thrombin generation test , thrombin dynamics test , thromboelastography ), an increase in blood levels of hemostasis activation markers, suppression of anticoagulant and fibrinolytic activity and a number of clinical conditions ^{[6] ]} .

• Thrombosis

1. ↑ ^{1 2} Monarch Disease Ontology release 2018-06-29sonu - 2018-06-29 - 2018.
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2. ↑ Mitchell RS, Kumar V, Abbas AK, Fausto N. Chapter 4 // Robbins Basic Pathology. - Eighth. - Philadelphia: Saunders, 2007 .-- ISBN 1-4160-2973-7 .
3. ↑ Heit JA Thrombophilia: common questions on laboratory assessment and management (neopr.) // Hematology Am. Soc. Hematol. Educ. Program. - 2007. - T. 2007 , No. 1 . - S. 127-135 . - DOI : 10.1182 / asheducation-2007.1.127 . - PMID 18024620 .
4. ↑ ^{1 2} Barkagan Z.S. Guide to hematology: in 3 volumes / A.I. Vorobyov. - 3. - Moscow: Newdiamed, 2005. - T. 3. - 416 s.
5. ↑ Clark P., Brennand J., Conkie J. at al. Activated protein C sensitivity, protein C, protein S and coagulation in normal pregnancy // Thromb Haemost .. - 1998. - Vol. 79 . - S. 1166-1170 .
6. ↑ A.P. Momot, L.P. Tsyvkina, I.A. Taranenko and others. Modern methods for recognizing the state of thrombotic readiness / A.P. Momot. - Barnaul: Ed. Alt. Univ., 2011 .-- 138 p. - ISBN 978-5-7904-1176-2 .