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State-of-the-Art Review : G to A 20210 Prothrombin Polymorphism and Venous Thrombosis: Simple Association or Causal Relationship?

Address correspondence and reprint requests to Antonio Girolami, M.D. Institute of Medical Semeiotics, Via Ospedale Civile 105, 35100 Padova, Italy. A new coagulation disorder recently maintained to be a cause of thrombophilia and/or thrombosis is the G to A nt 20210 prothrombin polymorphism (1). As usual when a &dquo;new&dquo; clotting abnormality or a &dquo;new&dquo; polymorphism is discovered, several claims are made because it is difficult to abstain from the temptation to generalize. This may convey wrong information to physicians. So far, most of the claims appear unjustified, and therefore the inclusion of this test in the battery of tests commonly carried out in the investigation of thrombotic or prothrombotic patients may create doubts among practicing physicians and patients alike. Furthermore, the request for inclusion of the test in the study of potentially thrombotic patients puts an additional burden on already strained Insurance and/or National Health Systems. In this regard, we think that some of the suggestions and some of the conclusions made in recent reviews