Factor V of Leiden

Cause of thrombophilia. Congenital anomaly of hemostasis. Autosomal dominant transmission of a mutation in the F5 gene on 1q23 present in the heterozygous state in 5-7 % of the Caucasian subjects. Prevalence of homozygotes: 1/5,000. 

Protein C is a protein of hepatic origin the synthesis of which depends on vitamin K: its activated form causes lysis of factors Va and VIIIa, and induces so an anticoagulant effect. The factor V mutation causes resistance to the action of activated protein C and exerts therefore a procoagulant effect. The risk of venous thrombosis is increased from 5 to 10 times in the heterozygous state and 50 to 100 times in the homozygous state.

This anomaly is also a cause of prolongation of APTT.


Anesthetic implications: 

prevention of thromboembolic complications (take advice from your hospital hemostasis specialist); increased risk of thrombosis with central venous lines; often treatment with vitamin K antagonists.


References : 


Updated: June 2019