Thrombophilia: some recent advances in understanding.

Thrombophilia is a term with many definitions although the majority include criteria such as thrombosis under the age of 45; recurrent thromboembolism and a positive family history. It reflects a disturbance in the normal delicate balance between pro- and anti-coagulation such as to favour inappropriate thrombosis. This review concentrates on the newly described phenomenon of activated protein C resistance while reviewing the natural anticoagulant system. It will also briefly examine the indications for 'thrombophilia' screening and the implications for individuals found to have an abnormality of their natural anticoagulants.