Table 1.

Most common thrombophilias and diagnostic laboratory studies.

ThrombophiliaLaboratory Tests
*if thrombophilic defect strongly suspected and level I testing is normal 
Level I Testing Factor V Leiden mutation Polymerase chain reaction or screening with clotting assay 
 Prothrombin 20210 mutation Polymerase chain reaction 
 Antithrombin deficiency Chromogenic or clotting assay 
 Protein C deficiency Chromogenic or clotting assay 
 Protein S deficiency Clotting assay or immunologic assay of free and total protein S antigen 
 Hyperhomocystenemia Fasting homocysteine 
 Elevated lipoprotein (a) ELISA 
 Antiphospholipid antibodies Phospholipid-based clotting assays, (PTT, DRVVT or Staclot LA) with confirmatory assay using exogenous phospholipid, ELISA assays for IgG and IgM antibodies directed against cardiolipin and β2 glycoprotein 
 Elevated factor VIII One-stage clotting assay, chromogenic assay 
Level II Testing* Dysfibrinogenemia Clotting assay (Clauss method), immunologic assay, thrombin time 
 Elevated factor IX, XI One-stage clotting assay 
ThrombophiliaLaboratory Tests
*if thrombophilic defect strongly suspected and level I testing is normal 
Level I Testing Factor V Leiden mutation Polymerase chain reaction or screening with clotting assay 
 Prothrombin 20210 mutation Polymerase chain reaction 
 Antithrombin deficiency Chromogenic or clotting assay 
 Protein C deficiency Chromogenic or clotting assay 
 Protein S deficiency Clotting assay or immunologic assay of free and total protein S antigen 
 Hyperhomocystenemia Fasting homocysteine 
 Elevated lipoprotein (a) ELISA 
 Antiphospholipid antibodies Phospholipid-based clotting assays, (PTT, DRVVT or Staclot LA) with confirmatory assay using exogenous phospholipid, ELISA assays for IgG and IgM antibodies directed against cardiolipin and β2 glycoprotein 
 Elevated factor VIII One-stage clotting assay, chromogenic assay 
Level II Testing* Dysfibrinogenemia Clotting assay (Clauss method), immunologic assay, thrombin time 
 Elevated factor IX, XI One-stage clotting assay 
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