Question: My husband has something called Factor V Leiden. He was recently hospitalized for a blood clot in his leg, and we were told he probably will need to be on blood thinners for the rest of his life. He has been healthy and active all his life, so this came as a shock. Can you tell me more about this?
Answer: Factor V Leiden (the "V" is the Roman numeral for 5) is one of the most common conditions that nobody has ever heard of. Factor V is one of 12 clotting factors, or proteins, necessary for the normal sequence of events that produces a blood clot in the body.
Factor V Leiden is an inherited disorder. It is the result of a mutation in one of the genes responsible for producing Factor V. In this disorder, the normal process of inactivating Factor V to prevent too much blood clotting is affected, and individuals are at higher risk for blood clots in the legs, a condition called deep venous thrombosis, or DVT.
DVT can cause problems in the legs such as pain and swelling, but the real danger is that blood clots may be swept up the veins to the heart and from there into the veins in the lungs. This occurrence, called pulmonary embolism, can be fatal if the clots are big enough or if there are enough of them.
People who inherit the gene mutation for Factor V Leiden from one parent have eight times the normal risk of DVT. Those who inherit it from both parents have an 80 times greater risk. It is most common in Caucasians. Because testing for Factor V Leiden is not routine, it is hard to know exactly how many people have this, but it's estimated that 5 percent of the population of the U.S. and Europe have it from one parent and that one in 5,000 have it from both. Other factors can increase the risk of blood clots in those with Factor V Leiden. They include pregnancy, smoking, obesity, trauma, surgery and hormone therapy such as the use of birth control pills.
Inactivity is a risk factor for DVT. Patients who are bedridden for prolonged periods because of illness or after surgery have a much higher risk than normal. A common scenario is the person who is sitting for a long time while traveling.
Richard Carlson, best-selling author of numerous books, including the popular Don't Sweat the Small Stuff … And It's All Small Stuff, died at age 45 from a pulmonary embolism that led to a fatal heart attack while he was on a cross-country flight. People who sit for extended periods for any reason should make it a habit to regularly get up and walk around to keep blood moving in their legs.
Patients at higher-than-normal risk of DVT and pulmonary embolism can be managed several ways. The most common method is to place them on blood thinners. A number of drugs affect the clotting sequence and reduce the risk of clots. The most widely used is Coumadin. People with Factor V Leiden may need to take Coumadin throughout their lives. Fortunately, most people with Factor V Leiden never experience a problem.
Richard T. Bosshardt is a plastic surgeon in Tavares. If you have a medical question, send it to him at 1879 Nightingale Lane, Suite A-2, Tavares, FL 32778, or send e-mail to firstname.lastname@example.org.