Abstract
We describe the case of a 39-year-old woman who suffered two iliofemoral venous thromboses, a cerebral ischemic infarct and recurrent fetal loss. Initial studies showed high levels of antiphospholipid antibodies (APAs) and a moderate thrombocytopenia. After her second miscarriage, laboratory diagnosis revealed that the woman was heterozygous for the factor V Leiden mutation and had a functional protein S deficiency as well as anti-protein S and anti-beta 2-glycoprotein I antibodies. The impairment of the protein C pathway at various points could well explain the recurrent thromboses in the patient and supports the role of a disturbed protein C system in the pathophysiology of thrombosis in patients with APAs.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Abortion, Habitual / etiology*
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Activated Protein C Resistance / complications*
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Activated Protein C Resistance / genetics
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Adult
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Antibodies, Antiphospholipid / blood
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Antibodies, Antiphospholipid / immunology*
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Antibody Specificity
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Antiphospholipid Syndrome / complications*
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Antiphospholipid Syndrome / immunology
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Autoantibodies / blood
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Autoantibodies / immunology
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Autoimmune Diseases / blood
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Autoimmune Diseases / complications*
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Autoimmune Diseases / immunology
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Brain Ischemia / etiology
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Cerebral Infarction / etiology
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Factor V / analysis*
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Female
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Genetic Predisposition to Disease
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Glycoproteins / immunology
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Heterozygote
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Humans
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Lupus Coagulation Inhibitor / blood
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Pregnancy
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Pregnancy Complications / immunology
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Pregnancy Complications, Hematologic
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Protein S / immunology
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Thrombophilia / etiology*
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Thrombophilia / genetics
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Thrombophilia / immunology
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Thrombophlebitis / etiology
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beta 2-Glycoprotein I
Substances
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Antibodies, Antiphospholipid
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Autoantibodies
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Glycoproteins
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Lupus Coagulation Inhibitor
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Protein S
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beta 2-Glycoprotein I
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factor V Leiden
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Factor V