Thrombophilia testing and diagnostic dilemma – a tertiary centre experience

Thrombophilia testing in patients taking direct oral anticoagulants. Handle with care

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We read with interest the recent letter of Chandrashekar, who further emphasized that results of thrombophilia testing may be confounded by the incident administration of oral vitamin K antagonists (VKAs), and that this potential interference may be detected by elevated prothrombin time (PT) and activated partial thromboplastin time (APTT) [1]. This was also seen in work previously published by one of us [2], where an alarming 80% of so-called low protein C, protein S and/or antithrombin levels in diagnostic test practice derived from cases likely to be on conventional anticoagulant therapy (VKAs or heparin) at the time of testing.

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