Advertisement
Research Article| Volume 16, ISSUE 3, P241-245, May 1994

Download started.

Ok

Childhood stroke associated with familial protein S deficiency

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      Cerebral infarction is a rare pathology among children and its etiology can be identified in almost two-thirds of cases. The remaining one-third are considered idiopathic. Recently, inherited disorders of blood coagulation predisposing to thrombosis have been taken into account as a possible cause of childhood stroke. We describe here a case of a 6-year-old child presenting with ischemic stroke and protein S (PS) defect. The family study suggested inheritance of the defect. The immunological characterization of PS in the affected family members was consistent with a defect mainly in the free form of PS. In the case here reported no associated predisposing condition to stroke could be identified but familial PS defect was found. No therapy was administered. Nevertheless symptoms disappeared spontaneously and there were no recurrences at the 1 year follow-up. Diagnostic imaging techniques demonstrated that a reduction in the cerebral ischemic area had occurred 2 months after the stroke.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Brain and Development
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      Reference

        • Esmon CT
        The protein C anticoagulant pathway.
        Arteriosclerosis Thrombosis. 1992; 12: 135-145
        • Comp PC
        • Nixon RR
        • Cooper MR
        • Esmon CT
        Familial protein S deficiency is associated with recurrent thrombosis.
        J Clin Invest. 1984; 74: 2082-2088
        • Engesser L
        • Broekmans AW
        • Briet EE
        • Brommer EJP
        • Bertina RM
        Hereditary protein S deficiency: clinical manifestations.
        Ann Intern Med. 1987; 106: 677-682
        • Simioni P
        • Zanardi S
        • Saracino A
        • Girolami A
        Occurrence of arterial thrombosis in a cohort of patients with hereditary deficiency of clotting inhibitors.
        J. Med. 1992; 23: 61-74
        • Allaart CF
        • Aronson DC
        • Ruys TH
        • et al.
        Hereditary protein S deficiency in young adults with arterial occlusive disease.
        Thromb Haemost. 1990; 64: 206-210
        • Siè P
        • Boneu B
        • Biermè R
        • Wiesel ML
        • Grunebaum L
        • Cazenave JP
        Arterial thrombosis and protein S deficiency.
        Thromb Haemost. 1989; 62: 1040
        • Girolami A
        • Simioni P
        • Lazzaro AR
        • Cordiano I
        Severe arterial cerebral thrombosis in a patient with protein S deficiency (moderately reduced total and markedly reduced free protein S): a family study.
        Thromb Haemost. 1989; 61: 144-147
        • Gomez-Aranda F
        • Lopez Dominguez JM
        • Rivera Fernandez V
        • Garcia EM
        Stroke and familial protein S deficiency.
        Stroke. 1992; 23: 299
        • Davous P
        • Horellou MH
        • Conard J
        • Samama M
        Cerebral infarction and familial protein S deficiency.
        Stroke. 1990; 21: 1760-1761
        • Israels SJ
        • Seshia SS
        Childhood stroke associated with protein C or deficiency.
        J. Pediatr. 1987; 111: 562-564
        • Whitlock JA
        • Janco RL
        • Phillips JA
        Inherited hypercoagulable states in children.
        Am J Pediatr Hemat Oncol. 1989; 11: 170-173
        • Girolami A
        • Lazzarin M
        • Scarpa R
        • Brunetti A
        Further studies on the abnormal factor X (Factor X Friuli) coagulation disorder. A report of another family.
        Blood. 1979; 37: 534-541
        • Girolami A
        • Simioni P
        • Lazzaro AR
        • Girolami B
        • Prandoni P
        A family with abnormal protein C (Protein C Padua) and a thrombotic tendency.
        Haematologia. 1993; 25: 25-33
        • Simioni P
        • Zanardi S
        • Prandoni P
        • Girolami A
        Combined inherited protein S and heparin co-factor II deficiency in a patient with upper limb thrombosis: a family study.
        Thromb Res. 1992; 67: 23-30
        • Laurell CB
        Quantitative estimation of proteins by electrophoresis of human serum proteins.
        Anal Biochem. 1966; 15: 45-52
        • Dahlback B
        • Carlsson M
        • Svensson PJ
        Familial thrombophilia due to a previously unrecognized mechanism characterized by poor anticoagulant response to activated protein C: prediction of a cofactor to activated protein C.
        in: 5th edn. Proc Natl Acad Sci USA. 90. 1993: 1004-1008
        • Eeg-Olofsson O
        • Ringheim Y
        Stroke in children. Clinical characteristics and prognosis.
        Acta Paediatr Scand. 1983; 72: 391-395
        • Schoenberg BS
        • Mellinger JF
        • Schoenberg DG
        Cerebrovascular disease in infants and children. a study of incidence, clinical features, and survival.
        Neurology. 1978; 28: 763-768
        • Pellegrino A
        • Zanesco L
        • Battistella A
        Coagulopathies and vasculopathies.
        in: Raimondi AJ Choux M Di Rocco C Cerebrovascular diseases in children. Springer, New York1992: 188-205
        • Hughes GRV
        The antiphospholipid syndrome: ten years on.
        Lancet. 1993; 342: 341-344
        • Devilat M
        • Toso M
        • Morales M
        Childhood stroke associated with protein C or S deficiency and primary antiphospholipid syndrome.
        Pediatr Neurol. 1993; 9: 67-70
        • Roddy SM
        • Giang DW
        Antiphospholipid antibodies and stroke in an infant.
        Pediatrics. 1991; 87: 933-935
        • Uysal S
        • Anlar B
        • Altay C
        • Kirazli S
        Role of protein C in childhood cerebrovascular occlusive accidents.
        Eur J Pediatr. 1989; 149: 216-218
        • Girolami A
        The hereditary thrombosis.
        in: Neri Serneri GG Gensini GF Abbate R Prisco D Thrombosis: An update. Scientific, Florence1992: 89-106