ARMS test for diagnosis of factor V(Leiden) mutation, a common cause of inherited thrombotic tendency

Chandri N. Yandava, David C. Zappulla, Bruce R. Korf, Ellis J. Neufeld

Research output: Contribution to journalArticlepeer-review


We developed a simple and rapid amplification-refractory mutation system (ARMS) assay for the factor V mutation [R506Q] (factor V(Leiden)), which results in the autosomal dominant thrombotic tendency, resistance to activated protein C (rAPC). PCR primers within Exon 10 of the factor V gene were designed. A common upstream primer was paired with either a mutant or wild-type-specific downstream primer. The 3'-most nucleotide of the specific primers recognized either the mutant or normal allele, and the 3' penultimate nucleotide was mismatched to enhance specificity of the reaction. The assay was validated using authentic factor V(Leiden) DNA samples. Seven of 103 hematologically normal children (6.8%) were found to be heterozygotes. Among 27 patients studied by the rAPC assay, ARMS assay and rAPC results were concordant in 28. Among these were a 1-year-old child with a calcified clot in the inferior vena cava. Both the patient and his father were heterozygous for the mutation and both had abnormal rAPC assays. rAPC and factor V(Leiden) assays were discordant in a young girl with a history of stroke. Biochemical rAPC assay was abnormal, while ARMS assay revealed amplification only with wild-type primers, suggesting a non-[R506Q] mechanism for rAPC. This assay will be a valuable tool for studying subjects with thromboses and their family members.

Original languageEnglish (US)
Pages (from-to)414-417
Number of pages4
JournalJournal of Clinical Laboratory Analysis
Issue number6
StatePublished - Jan 1 1996
Externally publishedYes


  • activated protein C resistance
  • amplification refractory mutation system
  • inherited thrombotic tendency
  • polymerase chain reaction

ASJC Scopus subject areas

  • Immunology and Allergy
  • Hematology
  • Public Health, Environmental and Occupational Health
  • Clinical Biochemistry
  • Medical Laboratory Technology
  • Biochemistry, medical
  • Microbiology (medical)


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