Ischemic Stroke with Protein S Deficiency Treated by Apixaban.
Brain Ischemia
/ diagnosis
Calcium-Binding Proteins
/ genetics
Factor Xa Inhibitors
/ therapeutic use
Genetic Predisposition to Disease
Humans
Male
Middle Aged
Mutation, Missense
Protein S
Protein S Deficiency
/ complications
Pyrazoles
/ therapeutic use
Pyridones
/ therapeutic use
Secondary Prevention
Stroke
/ diagnosis
Treatment Outcome
Venous Thrombosis
/ diagnosis
Stroke
apixaban
atherosclerosis
protein S deficiency
Journal
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
ISSN: 1532-8511
Titre abrégé: J Stroke Cerebrovasc Dis
Pays: United States
ID NLM: 9111633
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
12
11
2019
revised:
03
12
2019
accepted:
16
12
2019
pubmed:
17
1
2020
medline:
21
7
2020
entrez:
17
1
2020
Statut:
ppublish
Résumé
A 57-year-old man with atherosclerosis obliterans was admitted with sudden-onset sensory aphasia and right hemiparesis. Brain MRI revealed acute cerebral infarctions in the left temporal lobe and magnetic resonance angiography showed occlusion of the posterior branch of the left middle cerebral artery. Transesophageal echocardiography and ultrasonography respectively confirmed a patent foramen ovale and deep vein thrombosis in the bilateral femoral veins. Blood findings showed low protein S antigen, low protein S activity, and a missense mutation of the PROS 1 gene. The administration of apixaban 10 mg BID prevented ischemic stroke recurrence and decreased the deep vein thrombosis. These outcomes indicated that apixaban may be alternative to warfarin for the secondary prevention of ischemic stroke in a patient with a protein S deficiency.
Identifiants
pubmed: 31941580
pii: S1052-3057(19)30713-X
doi: 10.1016/j.jstrokecerebrovasdis.2019.104608
pii:
doi:
Substances chimiques
Calcium-Binding Proteins
0
Factor Xa Inhibitors
0
PROS1 protein, human
0
Protein S
0
Pyrazoles
0
Pyridones
0
apixaban
3Z9Y7UWC1J
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
104608Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.