What Is A Tendency To Thrombosis?

Thrombosis tendency: what is it?

In order for the blood to flow unhindered and to react to changes in its composition and damage to the vessel wall, it needs a balance between fibrinolysis (makes the blood more fluid) and clotting (makes the blood thicker). There should never be an uncontrolled activation of blood clotting in the body.

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• causes
• Congenital tendency to thrombosis
• Acquired propensity for thrombosis
• Individual risk

causes

Uncontrolled blood clotting would clog the vessels and that would be a life-threatening condition. Likewise, there should be no excessive inhibition of blood clots - dangerous bleeding would result. A tendency to thrombosis arises when the blood clotting is more pronounced than normal. Blood clotting factors are required. These are proteins formed by the liver and important components of the blood fluid (blood plasma). Most blood coagulation factors are involved in causing blood to clot (in the formation of a blood clot). But there are also coagulation factors in the blood that have the opposite effect - anticoagulant substances. Among other things, these are responsible for controlling blood clotting.

A tendency to thrombosis can occur if

• the blood clotting factors increased,
• the regulation of the blood platelets (thrombocytes) is disturbed or
• the fibrinolysis is decreased.

Other risk factors include hormonal contraceptives (eg the “pill”), surgery, cancer and smoking. A distinction is made between congenital (hereditary) and acquired tendency to thrombosis.

Congenital tendency to thrombosis

Congenital thrombophilias exist from birth, but symptoms often only appear in the course of life. Thromboses usually occur before the age of 40. In rare cases, however, some genetic defects can be so pronounced that those affected are not viable.

APC resistance

The congenital APC (activated protein C) resistance is the most common congenital tendency to thrombosis in Central Europe. It arises in 90 percent of cases as a result of a mutation in the factor V gene (factor V Leiden mutation). As a result of this disorder, the coagulation factor V can no longer be recognized by activated protein C (APC), as a result of which protein C loses its anticoagulant activity. If this protein is suppressed, venous thrombosis occurs more easily. The Factor V Leiden mutation was named after the place where it was discovered, Leiden in the Netherlands. For more information, see APC Resistence.

Prothrombin mutation G20201A

A change in the genetic material on the prothrombin gene increases the formation of the substance thrombin, and thus the blood clots more easily.

Disorders of antithrombin III, protein C or protein S

Antithrombin III, Protein C and Protein S have something in common: They are all opponents of blood clotting. Antithrombin III plays the most important role in this. If these proteins are disrupted, thrombosis can result. You can find more information under:

• Antithrombin III
• Protein C
• Protein S

Other inherited thrombosis factors include decreased fibrinolysis in the case of a lack of plasminogen and so-called dysfibrinogenemia.

Acquired propensity for thrombosis

An acquired tendency to thrombosis does not exist from birth. The following factors, among others, can promote the formation of blood clots:

• Cancer (e.g. lung or prostate),
• Syndromes (e.g. antiphospholipid antibody syndrome / lupus, nephrotic syndrome with impaired filter function of the kidneys),
• Medication (e.g. treatment with estrogens or taking the pill),
• Pregnancy,
• Lack of exercise (e.g. after an operation due to immobilization, bed rest, long-haul flights),
• high age.

Individual risk

The individual risk of actually developing a blood clot with a tendency to thrombosis varies. It depends on the genetic defect or other possible causes. Characteristics range from a slight tendency to form blood clots without symptoms to severe, often recurring thrombosis of arteries and / or veins. Taking the pill usually increases the risk significantly. Antithrombin III deficiency presents the highest risk of thrombosis in the case of genetic defects. In the case of the antiphospholipid-antibody syndrome, there is a strong tendency to thrombosis, which is associated with frequent abortions or infant deaths and vascular blockages in the brain.