Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (915 page)

   A first VTE in an individual with a first-degree family member with VTE before age 50 years

   Women with unexplained fetal loss occurring after 10 weeks of gestation

   Factor V Leiden testing may be considered in the following cases:

   In women with unexplained severe preeclampsia, placental abruption, or a fetus with intrauterine growth retardation

   A first VTE related to the use of tamoxifen or other selective estrogen receptor modulators

   Female smokers younger than age 50 years with an MI or stroke

   Individuals older than age 50 years with a first provoked VTE in the absence of malignancy or an intravascular device

   Asymptomatic adult family members of a known factor V Leiden proband, especially those with a strong family history of VTE at a young age

   Asymptomatic female family members of probands with known factor V Leiden thrombophilia who are pregnant or who are considering oral contraceptive use or pregnancy

   Women with recurrent unexplained first-trimester pregnancy loss with or without second- or third-trimester pregnancy loss

   Children with arterial thrombosis

   Limitations

   The results of a genetic test may be affected by DNA rearrangements, blood transfusion, bone marrow transplantation, or rare sequence variations.