Hypoprothrombinemia Follow-up

  • Author: J Nathan Hagstrom, MD; Chief Editor: Robert J Arceci, MD, PhD   more...
 
Updated: Feb 29, 2012
 

Further Outpatient Care

Patients with inherited prothrombin deficiency should receive follow up with a hematologist at a comprehensive center that cares for patients with bleeding disorders. Follow-up should occur on a yearly basis as a minimum.

A hematologist should initially evaluate patients with acquired hypoprothrombinemia. Follow-up care depends on the underlying cause.

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Prognosis

Patients with lupus anticoagulant-hypoprothrombinemia syndrome after a viral infection can be expected to spontaneously recover.

Few patients with systemic lupus erythematosus–associated lupus anticoagulant-hypoprothrombinemia syndrome (most cases) have spontaneously recovered. Immunosuppressive therapy successfully controls bleeding and increases prothrombin levels in most patients, though some have had a recurrence of symptoms when drug therapy was tapered.

The prognosis for patients with inherited prothrombin deficiency varies. The degree of deficiency does not always predict the clinical course, as patients with severe deficiency with only mild bleeding tendencies have been reported. Impairment of the procoagulant and anticoagulant activities of prothrombin are speculated to result in a delicate coagulation balance in patients who have mild or no symptoms.

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Contributor Information and Disclosures
Author

J Nathan Hagstrom, MD  Division Head and Director, Hematology-Oncology, Connecticut Children's Medical Center; Associate Professor of Pediatrics, University of Connecticut

J Nathan Hagstrom, MD is a member of the following medical societies: American Society of Hematology, American Society of Pediatric Hematology/Oncology, and International Society on Thrombosis and Haemostasis

Disclosure: Nothing to disclose.

Coauthor(s)

James L Harper, MD  Associate Professor, Department of Pediatrics, Division of Hematology/Oncology and Bone Marrow Transplantation, Associate Chairman for Education, Department of Pediatrics, University of Nebraska Medical Center; Assistant Clinical Professor, Department of Pediatrics, Creighton University School of Medicine; Director, Continuing Medical Education, Children's Memorial Hospital; Pediatric Director, Nebraska Regional Hemophilia Treatment Center

James L Harper, MD is a member of the following medical societies: American Academy of Pediatrics, American Association for Cancer Research, American Federation for Clinical Research, American Society of Hematology, American Society of Pediatric Hematology/Oncology, Council on Medical Student Education in Pediatrics, and Hemophilia and Thrombosis Research Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Gary R Jones, MD  Associate Medical Director, Clinical Development, Berlex Laboratories

Gary R Jones, MD is a member of the following medical societies: American Academy of Pediatrics, American Society of Pediatric Hematology/Oncology, and Western Society for Pediatric Research

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Gary D Crouch, MD  Associate Professor, Program Director of Pediatric Hematology-Oncology Fellowship, Department of Pediatrics, Uniformed Services University of the Health Sciences

Gary D Crouch, MD is a member of the following medical societies: American Academy of Pediatrics and American Society of Hematology

Disclosure: Nothing to disclose.

Samuel Gross, MD  Professor Emeritus, Department of Pediatrics, University of Florida; Clinical Professor, Department of Pediatrics, University of North Carolina; Adjunct Professor, Department of Pediatrics, Duke University

Samuel Gross, MD is a member of the following medical societies: American Association for Cancer Research, American Society for Blood and Marrow Transplantation, American Society of Clinical Oncology, American Society of Hematology, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Chief Editor

Robert J Arceci, MD, PhD  King Fahd Professor of Pediatric Oncology, Professor of Pediatrics, Oncology and the Cellular and Molecular Medicine Graduate Program, Kimmel Comprehensive Cancer Center at Johns Hopkins University School of Medicine

Robert J Arceci, MD, PhD is a member of the following medical societies: American Association for Cancer Research, American Association for the Advancement of Science, American Pediatric Society, American Society of Hematology, and American Society of Pediatric Hematology/Oncology

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous coauthor Sara E Tisdale, MD, to the development and writing of this article.

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