Prothrombin, mutation G20210A of the

[MIM 614 930, 188 050]

Most common cause of thrombophilia following the Leyden factor V mutation. Autosomal dominant transmission of a mutation of the F2 gene  (11p11-q12). This mutation increases the blood level of prothrombin by about 30 % in heterozygous and 70 % in homozygous people. Its clinical expression is highly variable: many heterozygous or homozygous carriers never develop thrombosis while most heterozygous carriers with thromboembolic manifestations remain asymptomatic until adulthood and some present recurrent thrombosis before 30 years of age. The risk of thrombosis is 3 to 4 times higher than the normal population. The most common clinical manifestation is venous thrombosis of the lower limbs or pulmonary embolisms.


This diagnosis must be kept in mind in case of:


Anesthetic implications 

in case of a history of thrombosis or at risk surgery: low molecular weight heparin perioperatively and brindging with antivitamin K.

Risk of heparin-induced thrombopenia.


References : 

-         Shen E, Uemura T, Kadry Z, Sathishkumar S.
Successful living donor kidney transplantation in a patient with prothrombin gene mutation : case report and literature review.
J Anesth Clin Pharmacol 2014 ; 30 : 106-8


Updated: October 2020