- Author
-
E.N. Hamulyák
- Title
- Thrombophilia
- Subtitle
- Consequences in pregnancy & malignancy
- Supervisors
-
S. Middeldorp
- Co-supervisors
- Award date
- 25 June 2021
- Number of pages
- 243
- ISBN
- 9789464166422
- Document type
- PhD thesis
- Faculty
- Faculty of Medicine (AMC-UvA)
- Abstract
-
The term thrombophilia refers to an increased tendency to develop thrombosis. Inherited thrombophilia encompasses deficiencies of the natural anticoagulants antithrombin, protein C or protein S, and the more common gain-of-function mutations Factor V Leiden and prothrombin G20210A. Thrombophilia also includes acquired conditions, of which antiphospholipid syndrome and myeloproliferative neoplasms are the most well-established. The clinical consequences of thrombophilia range from the aforementioned increased risk of thrombosis to choice of antithrombotic treatment in these specific populations.
Understanding of the association between the various types of thrombophilia and the characterizing clinical aspects has increased substantially over the past two decades. Yet, several important clinically relevant issues remain unresolved. Some of these are women-specific: Can antithrombotic treatment improve pregnancy outcomes in women with inherited or acquired thrombophilia? Does a history of uncommon site venous thrombosis, such as splanchnic vein thrombosis, warrant vigilance in counseling for pregnancy? What is the optimal management of anticoagulant-associated heavy menstrual bleeding in young women? Other outstanding topics concern antithrombotic treatment in patients with a known malignancy, which leads to acquired thrombophilia, who are at high risk of both thrombosis and bleeding: What is the ideal long-term treatment of venous thromboembolism in patients with a myeloproliferative neoplasm? How to manage antithrombotic treatment during thrombocytopenia? And can direct oral anticoagulants also be safely given in patients with brain metastases?
The studies described in the current thesis address these topics and aim to provide new insights on the clinical consequences of thrombophilia in pregnancy and malignancy. - Persistent Identifier
- https://hdl.handle.net/11245.1/f1353e97-0ccf-458a-a253-e5d9eff7732a
- Downloads
-
Thesis (complete)
Front matter
Chapter 1: General introduction & Outline of thesis
Chapter 2: Women’s health in the BMJ: A data science history
Chapter 3: Sex matters: Practice 5Ps when treating young women with venous thromboembolism
Chapter 4: Heavy menstrual bleeding on direct factor Xa inhibitors: Rationale and design of the MEDEA Study
Chapter 5: Progress of the ALIFE2 study: A dynamic road towards more evidence
Chapter 6: Antithrombotic therapy to prevent recurrent pregnancy loss in antiphospholipid syndrome
Chapter 7: Pregnancy outcomes in Budd-Chiari syndrome or portal vein thrombosis
Chapter 8: A systematic review of antithrombotic treatment of venous thromboembolism in patients with myeloproliferative neoplasms
Chapter 9: Management of antithrombotics and outcomes in patients with hematological malignancy and thrombocytopenia
Chapter 10: Intracranial hemorrhage with direct oral anticoagulants in patients with brain metastases
Chapter 11: Summary & Future perspectives
Nederlandse samenvatting; Stellingen; List of peer-reviewed publications; Portfolio; Dankwoord; Curriculum vitae
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