factor VIII

• Factor VIII inhibitor is found in _% of hemophilia patients receiving replacement therapy. It may also develop in patients with _ problems, women after _, and patients with _ and _ disorders, or it may develop in response to _.

  10%-20%; immunologic; childbirth;

  lymphoproliferative; plasma cell disorders; medications
• _ is an IgG immunoglobulin with an inhibitory effect that is time and temperature dependent. The presence of factor VIII inhibitor causes an __in the face of a normal prothrombin time. 


  Factor VIII inhibitor; elevated APTT
• The APTT would not be corrected by mixing studies if __ was present.

  lupus anticoagulant
• lupus anticoagulant is not associated with _ unless it coexists with thrombocytopenia

  bleeding
• abnormal tendency towards excessive thrombosis

  Thrombophilia
• common cause of arterial thrombosis(3):

  Antiphospholipid syndrome

  Prothrombin mutation

  HIT syndrome
• rare cause of arterial thrombosis(2):

  Elevated Plasminogen activator inhibitor activity

  Hyperchromocysteinemia
• often result to myocardial infarction:

  Arterial Thrombosis
• Often result to Deep vein thrombosis:

  Venous thrombosis
• also consider:

  anomalous coronary arteries

  vasculitis

  arterial thrombosis
• common cause of venous thrombosis:

  Factor V Leiden mutation

  Prothrombin mutation

  Antiphospholipid syndrome

  Protein C deficiency

  Protein S deficiency

  Antithrombin deficiency
• Rare cause of Venous thrombosis:

  Hyperchromocysteinemia

  Heparin cofactor II
• Also consider venous thrombosis:

  Pregnancy

  Immobilization

  Trauma
• Degrades factor Va and VIIIa Vitamin K dependent

  Protein C
• Degrades factor Va and VIIIa

  Protein S
• Major inhibitor of thrombin, also inhibits factors IXa, Xa, Xia. Xlla, kallikrein and plasmin

  Anti-thrombin III
• Inhibits thrombin

  Heparin cofactor II
• Co-factor of Protein C

  Protein-S
• Forms a complex with thrombin, kallikrein and plasmin

  a2-macroglobulin
• Inhibits the Vila-tissue factor complex

  EPI (extrinsic pathway inhibitor) LACI (lipoprotein associated coagulation inhibitor)
• Inactivator of factor Xlla and kallikrein, it also inhibits factor Xia and plasmin

  C1 inhibitor
• Inhibitor of thrombin, Xa and Xla

  a1-antitrypsin