Frequency
Factor V Leiden is the most common inherited form of thrombophilia. Between 3 and 8 percent of people with European ancestry carry one copy of the factor V Leiden mutation in each cell, and about 1 in 5,000 people have two copies of the mutation. The mutation is less common in other populations.
Causes
A particular mutation in the F5 gene causes factor V Leiden thrombophilia. The F5 gene provides instructions for making a protein called coagulation factor V. This protein plays a critical role in the coagulation system, which is a series of chemical reactions that forms blood clots in response to injury.
The coagulation system is controlled by several proteins, including a protein called activated protein C (APC). APC normally inactivates coagulation factor V, which slows down the clotting process and prevents clots from growing too large. However, in people with factor V Leiden thrombophilia, coagulation factor V cannot be inactivated normally by APC. As a result, the clotting process remains active longer than usual, increasing the chance of developing abnormal blood clots.
Other factors also increase the risk of developing blood clots in people with factor V Leiden thrombophilia. These factors include increasing age, obesity, injury, surgery, smoking, pregnancy, and the use of oral contraceptives (birth control pills) or hormone replacement therapy that contains estrogen. The risk of abnormal clots is also much higher in people who have a combination of the factor V Leiden mutation and another mutation in the F5 gene. Additionally, the risk is increased in people who have the factor V Leiden mutation together with a mutation in another gene involved in the coagulation system.
Inheritance
The chance of developing an abnormal blood clot depends on whether a person has one or two copies of the factor V Leiden mutation in each cell. People who inherit two copies of the mutation, one from each parent, have a higher risk of developing a clot than people who inherit one copy of the mutation. Considering that about 1 in 1,000 people per year in the general population will develop an abnormal blood clot, the presence of one copy of the factor V Leiden mutation increases that risk to 3 to 8 in 1,000, and having two copies of the mutation may raise the risk to as high as 80 in 1,000.
Other Names for This Condition
- APC resistance, Leiden type
- Hereditary resistance to activated protein C
Additional Information & Resources
Genetic Testing Information
Patient Support and Advocacy Resources
Clinical Trials
Catalog of Genes and Diseases from OMIM
Scientific Articles on PubMed
References
- Calderwood CJ, Greer IA. The role of factor V Leiden in maternal health and the outcome of pregnancy. Curr Drug Targets. 2005 Aug;6(5):567-76. doi: 10.2174/1389450054546024. Citation on PubMed
- Grody WW, Griffin JH, Taylor AK, Korf BR, Heit JA; ACMG Factor V. Leiden Working Group. American College of Medical Genetics consensus statement on factor V Leiden mutation testing. Genet Med. 2001 Mar-Apr;3(2):139-48. doi: 10.1097/00125817-200103000-00009. No abstract available. Erratum In: Genet Med. 2021 Dec;23(12):2463. doi: 10.1038/s41436-021-01108-x. Citation on PubMed or Free article on PubMed Central
- Horne MK 3rd, McCloskey DJ. Factor V Leiden as a common genetic risk factor for venous thromboembolism. J Nurs Scholarsh. 2006;38(1):19-25. doi: 10.1111/j.1547-5069.2006.00072.x. Citation on PubMed
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- Major DA, Sane DC, Herrington DM. Cardiovascular implications of the factor V Leiden mutation. Am Heart J. 2000 Aug;140(2):189-95. doi: 10.1067/mhj.2000.108241. No abstract available. Citation on PubMed
- Mann KG, Kalafatis M. Factor V: a combination of Dr Jekyll and Mr Hyde. Blood. 2003 Jan 1;101(1):20-30. doi: 10.1182/blood-2002-01-0290. Epub 2002 Aug 8. No abstract available. Citation on PubMed
- Ornstein DL, Cushman M. Cardiology patient page. Factor V Leiden. Circulation. 2003 Apr 22;107(15):e94-7. doi: 10.1161/01.CIR.0000068167.08920.F1. No abstract available. Citation on PubMed
- Pastori D, Menichelli D, Valeriani E, Pignatelli P. Factor V Leiden Thrombophilia. 1999 May 14 [updated 2024 May 16]. In: Adam MP, Feldman J, Mirzaa GM, Pagon RA, Wallace SE, Amemiya A, editors. GeneReviews(R) [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2025. Available from http://www.ncbi.nlm.nih.gov/books/NBK1368/ Citation on PubMed
- Rosendaal FR, Reitsma PH. Genetics of venous thrombosis. J Thromb Haemost. 2009 Jul;7 Suppl 1:301-4. doi: 10.1111/j.1538-7836.2009.03394.x. Citation on PubMed
- Rosendorff A, Dorfman DM. Activated protein C resistance and factor V Leiden: a review. Arch Pathol Lab Med. 2007 Jun;131(6):866-71. doi: 10.5858/2007-131-866-APCRAF. Citation on PubMed
- Segal JB, Brotman DJ, Necochea AJ, Emadi A, Samal L, Wilson LM, Crim MT, Bass EB. Predictive value of factor V Leiden and prothrombin G20210A in adults with venous thromboembolism and in family members of those with a mutation: a systematic review. JAMA. 2009 Jun 17;301(23):2472-85. doi: 10.1001/jama.2009.853. Citation on PubMed
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