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Fact Sheet
Prothrombin Gene Mutation
- increased risk of developing blood clots due to an increase in the level of prothrombin

Prothrombin Gene Mutation


Overview

The Prothrombin Gene Mutation is a change in the gene that controls a blood clotting protein that circulates in the blood called prothrombin. This particular gene change leads to an increase in the level of this protein in the blood.

How did I get Prothrombin Gene Mutation?

Prothrombin Gene Mutation is an inherited condition

We inherited one copy of each gene from each of our parents. One (or both) of your parents will have passed the Prothrombin Gene Mutation on to you and you may pass the condition onto your children.

How common is the Prothrombin Gene Mutation?

No. of people in Australia with the Prothrombin Gene Mutation

0

in 50 people

The Prothrombin Gene Mutation is relatively common – it occurs in about 1 in every 50 people in Australia. This mutation is more common than many other gene changes (mutations). Because the mutation is very common, it has been suggested that there is some “benefit” in having the Prothrombin Gene Mutation.

What are the main problems with having the Prothrombin Gene Mutation?

The main problem with having the Prothrombin Gene Mutation is having an increased risk of developing blood clots.

  • Blood clots can occur in blood vessels and can sometimes travel to different parts of the body including the lungs.
  • Having the Prothrombin Gene Mutation increases your risk of having a blood clot.
  • If you have one copy of the Prothrombin Gene Mutation (also called being a heterozygote for this gene), you are at around 3 times more at risk of developing a blood clot compared to someone your age who does not have this gene change

Am I going to get a blood clot because I have this mutation?

Most people with one copy of the Prothrombin Gene Mutation DO NOT develop blood clots.

  • Blood clots usually only develop when there are other “risk factors” for blood clots.
  • Blood clots develop when the circulation of the blood flow is reduced (e.g. after long flights, after surgery etc.) or in people with other serious medical conditions such as cancer or heart failure.

How does the use of the oral contraceptive pill affect the risk of developing a blood clot in women?

The use of the contraceptive pill can increase the risk of developing a blood clot.

  • Women on the pill have around a 3 – 4 fold increased risk of getting a blood clot compared to other women who are not on the pill.
  • If a woman also has one copy of the Prothrombin Gene Mutation, this risk increases to around 16 times the risk of having a clot on the pill.

These risks sound high, but clots are still relatively uncommon in the community.

Are there any benefits of having Prothrombin Gene Mutation?

Because individuals who have the Prothrombin Gene Mutation have blood that clots more easily, it has been suggested that this may be beneficial during times when bleeding occurs (e.g. during menstruation or after childbirth). This is only a theory and there have not been any studies to confirm this theory.


Treatment & Management

Is there any treatment for Prothrombin Gene Mutation?

No treatment to change genes is currently available. Most people who have the Prothrombin Gene Mutation do not require any treatment but need to be careful at times when the risk of getting a blood clot may be increased (e.g. after surgery, during long flights etc). [See information sheet on Blood Clots and Flights].

Sometimes people with the Prothrombin Gene Mutation may need to go on blood thinning medication (anticoagulation) to reduce the risk of developing blood clots. This will depend on lots of other factors including a past medical history of clots or a family history of blood clots.

Is there anything else I should do to protect my self against getting blood clots?

01.

Prevention

Maintaining a healthy weight, stopping smoking, staying active and keeping any other medical conditions under control should also help you protect against getting any blood clots.

02.

Tell your Treating Doctor

You should tell your doctor or surgeon that you have the Prothrombin Gene Mutation before any operations or prolonged periods of bed rest.

Genetic Diagnosis

Should my family be tested for the Prothrombin Gene Mutation?

Testing for the Prothrombin Gene Mutation is easily done – a simple blood test is all that is required.

Most people think testing is a good idea but you and your family should think carefully about testing for the Prothrombin Gene Mutation. There may be some change to health and life insurance policies. Clots in children are very uncommon so it is probably best to wait until children are older (usually in their late teens) and can decide if they want the testing performed.

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No. of people in Australia with the Prothrombin Gene Mutation

0

in 50 people

0

people in Melbourne

0

population of Melbourne*


What does having HS mean?

There are three main common problems associated with having HS:

01.

Anaemia

– this occurs because the red cells break down more quickly

02.

Jaundice

– when red cells break down they release a pigment called bilirubin which appears as a yellow colour in the skin and the eyes. Over a long period of time, the problem of jaundice can be associated with gall stones.

03.

Increase in the size of the spleen

– this is the site of the red cells breaking down. The spleen is a blood filter and some of the red cells can get caught up in the spleen


Diagnosis


Treatment & Management

What do I need to do now that I (or my child) has been diagnosed with Hereditary Spherocytosis?

Most patients with HS do not need to do much about their condition at all. The bone marrow has the capacity to increase the number of red cells it produces many fold and is able to keep up replacing the fragile cells.

A few things may be helpful:

01.

Regular blood tests

– to check on the level of haemolysis

02.

Folate supplementation

An important vitamin necessary for the bone marrow to function properly is folate. Folate is found in green leafy vegetables. Most people get enough folate in their diet but getting extra folate (particularly in HS if there is significant haemolysis – red cell breakdown) is generally recommended.

03.

Ultrasounds to exclude gall stones

It may also be important to make sure children and adults are not developing gall stones – an ultrasound of the gall bladder after that age of 5 years of age every 3 – 5 years there after, is the current recommendation.


Resources used to produce this information sheet.

  1. Investigation and management of heritable thrombophilia. British Journal of Haematology 114 (3), 512–528. 2001.


Further Questions?

The information presented in this fact sheet is intended as a general guide only.

Patients should seek further advice and information about Prothrombin Gene Mutation and their individual condition from their treating haematologist or doctor.

1000 563 Melbourne Haematology
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