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Editor's Correspondence
March 11, 2002

Testing for Hypercoagulable Disorders

Arch Intern Med. 2002;162(5):613. doi:

In their excellent review titled "An Update on Hypercoagulable Disorders," Federman and Kirsner1 recommend testing patients with a history of thrombosis at an early age for deficiencies of anti–thrombin III, protein C, and protein S and for the presence of antiphospholipid antibodies, factor V Leiden, prothrombin 20210A mutation, and hyperhomocysteinemia.

One must argue, however, that ordering all these tests would be an unreasonable drain on resources. Ordering the so-called hypercoagulation panel, though attractive, may have an economic and even a therapeutic shortcoming impact. Prioritizing the need to test and the yield of each test would seem a more appropriate approach.

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