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	Since this article does not have an abstract, we have provided the first 147 words of the full text and any section headings.

In their review of patent foramen ovale in cryptogenic stroke, Wu et al¹ include factor V Leiden, prothrombin 20210 mutation, proteins C and S deficiency, and antithrombin III deficiency among the thrombophilic abnormalities causing and predisposing to stroke and transient ischemic attack and recommend screening younger individuals presenting with stroke.

In contrast to the association between antiphospholipid antibodies and lupus anticoagulants and arterial thrombosis, these inherited thrombophilic abnormalities have been shown not to be significantly linked with stroke or transient ischemic attack.² The high prevalence of these abnormalities makes the probability of a coincidental finding high. Although factor V Leiden and prothrombin 20210 mutation may play a small role in a subtype of stroke,³ their inclusion in the routine investigation of ischemic stroke is not recommended by current guidelines.⁴

AUTHOR INFORMATION
Correspondence: Dr Butler, Department of Haematology, Falkirk Royal Infirmary, Major’s Loan, Falkirk FK1 5QE, Scotland (andrew.butler@fvah.scot.nhs.uk).

Andrew Butler, MRCP, MRCPath; Roddy Neilson, MRCP, MRCPath

1. Wu LA, Malouf JF, Dearani JA, et al. Patent foramen ovale in cryptogenic stroke: current understanding and management options. Arch Intern Med. 2004;164:950-956. FREE FULL TEXT 2. Karttunen V, Hiltunen L, Rasi V, et al. Factor V Leiden and prothrombin gene mutation may predispose to paradoxical embolism in subjects with patent foramen ovale. Blood Coagul Fibrinolysis. 2003;14:261-268. FULL TEXT | WEB OF SCIENCE | PUBMED 3. Walker ID, Greaves M, Preston FE, et al. Investigation and management of heritable thrombophilia. Br J Haematol. 2001;114:512-528. FULL TEXT | WEB OF SCIENCE | PUBMED 4. Hankey GJ, Eikelboom JW, van Bockxmeer FM, et al. Inherited thrombophilia in ischemic stroke and its pathogenic subtypes. Stroke. 2001;32:1793-1799. FREE FULL TEXT

Arch Intern Med. 2004;164:2502.

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RELATED ARTICLE

Patent Foramen Ovale in Cryptogenic Stroke: Current Understanding and Management Options
Lambert A. Wu, Joseph F. Malouf, Joseph A. Dearani, Donald J. Hagler, Guy S. Reeder, George W. Petty, and Bijoy K. Khandheria
Arch Intern Med. 2004;164(9):950-956.
ABSTRACT | FULL TEXT