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Thrombophilia Testing Timing — RACP Adult Medicine MCQ

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ModerateHaematologyThrombophilia Testing TimingRACP Adult Medicine

A 25-year-old woman has an unprovoked DVT. She has a strong family history of VTE (mother and sister both had PE before age 40). She is otherwise well. What is the most appropriate timing for thrombophilia testing?

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Correct answer: AAfter completing 3 months of anticoagulation

Thrombophilia testing should be performed after completing anticoagulation (wait ≥2 weeks after stopping DOAC, ≥4 weeks after warfarin for protein C/S and antithrombin). Testing during acute VTE or on anticoagulation gives unreliable results: acute thrombosis consumes anticoagulant proteins (falsely low protein C/S, antithrombin); warfarin reduces protein C/S; DOACs affect lupus anticoagulant and some clotting assays. Test panel: Factor V Leiden, prothrombin G20210A, antithrombin, protein C, protein S, antiphospholipid antibodies.

Reference: BSH – 2024 – Thrombophilia Testing; ISTH 2024