Antithrombin, protein C and protein S levels in 127 consecutive young adults with ischemic stroke

Douay, X.; Lucas, Christian; Caron, C; Goudemand, Jenny; Leys, Didier

doi:10.1111/j.1600-0404.1998.tb01731.x

Cited by 53 publications

(26 citation statements)

References 28 publications

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“…An association between young IS and inherited protein C deficiency has been reported in individual case reports [17]. However, larger studies failed to demonstrate this relationship [18]. Protein C deficiency alone does not appear to increase the risk or arterial thrombosis, slightly higher incidence of myocardial infarction is noted when it is coupled with other vascular risk factors [19, 20].…”

Section: Thrombophilic Disordersmentioning

confidence: 99%

Role of Investigating Thrombophilic Disorders in Young Stroke

Loh

Sharma

2011

Stroke Research and Treatment

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Our knowledge about various inherited and acquired causes of thrombophilic disorders has increased significantly during the past decade. Technology for various diagnostic tests for these rare disorders has matched the rapid advances in our understanding about the thrombophilic disorders. Inherited thrombophilic disorders predispose young patients for various venous or arterial thrombotic and thromboembolic episodes. Our understanding has also improved about various gene-gene and gene-environment interactions and their impact on the resultant heterogenous clinical manifestations. We describe various thrombophilic disorders, their diagnostic tests, pathogenic potential in isolation or with other concurrent inherited/acquired defects and possible therapeutic and prophylactic strategies. Better understanding, optimal diagnostic and screening protocols are expected to improve the diagnostic yield and help to reduce morbidity, disability, and mortality in relatively younger patients harbouring these inherited and acquired thrombophilic disorders.

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Section: Thrombophilic Disordersmentioning

confidence: 99%

Role of Investigating Thrombophilic Disorders in Young Stroke

Loh

Sharma

2011

Stroke Research and Treatment

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“…It has been shown that adults with homozygous antithrombin deficiency are at increased risk for both arterial and venous thrombosis [21][22][23]. However, Douay et al [24] observed the levels of antithrombin in 127 consecutive young adults with ischemic stroke, and found that hereditary deficiency of antithrombin is rare in ischemic stroke patients less than 45 years. Therefore, the authors concluded that antithrombin deficiency is not a significant risk factor for young ischemic stroke.…”

Section: Discussionmentioning

confidence: 97%

Antithrombin Cambridge II(A384S) mutation frequency and antithrombin activity levels in 120 of deep venous thrombosis and 150 of cerebral infarction patients in a single center in Southern China

Zhang¹,

Tang²,

Tang³

et al. 2010

Blood Coagulation &Amp; Fibrinolysis

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Antithrombin Cambridge II(A384S) mutation shows a relatively high frequency in western population. Some studies suggest that the mutation is an independent genetic risk factor both for deep vein thrombosis (DVT) and for arterial thrombosis, but whether the mutation has racial difference or has a general significance for thrombophilia remains unclear. In this study we performed an analysis of the prevalence of the mutation in Chinese southern population; Also, the antithrombin activity levels were evaluated in each investigated individual. The studies included 120 patients with DVT, 150 patients with cerebral infarction, and 110 controls. The mutation was detected using polymerase chain reaction/PvuII restrictive fragment length polymorphism procedures. Antithrombin activity assay was done using chromogenic substrate method. The results showed that no antithrombin Cambridge II mutation was detected in all three groups (DVT, cerebral infarction and controls), the incidence was 0/380. Plasma antithrombin activity was 91.37% +/- 16.15% in the DVT patients and 102.68% +/- 13.10% in the controls; the antithrombin activity was significantly reduced in the DVT group (P < 0.0001). In DVT patients, eight cases were identified as primary antithrombin deficiency, accounting for an incidence of 6.7%. No significant difference was found for antithrombin activity between cerebral infarction group and controls. These results suggest that antithrombin Cambridge II mutation has a racial difference, and may not be a valuable risk factor of thrombophilia in Asian population, and antithrombin deficiency remains a major genetic risk factor for DVT patients in China.

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“…Mayer et al [12] also supported the fact that acquired deficiency of free protein S is not a major risk factor for ischemic stroke. Douay et al [13] reported that hereditary deficiencies of coagulation inhibitors are rare in ischemic stroke patients under 45 years and their systematic detection seems to be of poor interest. Wiesel et al [14] studied 105 patients with protein S deficiency, out of which 14 had arterial thrombotic accidents involving the central nervous system or the myocardium, while most studies revealed a weaker association between these two [12].…”

Section: Discussionmentioning

confidence: 99%

Ischemic Stroke in Young due to Combined Protein C and S Deficiency

Patel¹,

Sachan²,

Gupta³

et al. 2013

JCR

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Abstract:WHO defines stroke as an event caused by the interruption of the blood supply to the brain, usually because a blood vessel bursts or is blocked by a clot. This cuts off the supply of oxygen and nutrients, causing damage to the brain tissue [1]. Globally, stroke is the third commonest cause of mortality [2] and the fourth leading cause of disease burden [3]. Ischemic stroke is the most common cerebrovascular disease, most often due to atherothrombotic diseases and uncommonly by disorders of hypercoagulation. Disorders of coagulation leading to thrombotic disorders are approximately 1% of all ischemic strokes and 4-8% of young strokes. Similarly combined deficiency of protein C and S can lead to hypercoagulable state and rarely present as cerebrovascular accident. We describe here a rare case of 27 year old male who presented with right middle cerebral artery territory infarct due to combined protein C and S deficiency.Key words: Stroke, Blood Coagulation, Protein C, Infarction, Middle Cerebral Artery, Brain. IntroductionCerebrovascular diseases are one of the common causes of high morbidity and mortality all over the world and out of all cerebrovascular diseases most of them are ischemic strokes (85%). Stroke in young individual poses a major problem as these young family members are the major income earner of the family. Abraham et al [4] from Vellore, South India reported that 25% cases of the stroke were less than 40 years of age. Other Indian studies have highlighted a high incidence 24-35% of stroke in young population [5]. Atherothrombotic diseases are most common cause for ischemic stroke, however disorder of coagulation although uncommon but can lead to hypercoagulability resulting in ischemic stroke. Case ReportA 27 year old male presented with complains of weakness in left side of body since last 10 days. General physical examination was unremarkable. Neurological examination revealed findings consistent with left-sided hemiparesis. No precipitating factors such as obesity, diabetes, hypertension, valvular heart disease, chronic drug intake, intravenous drug abuse and smoking were present. Family history was negative for vascular events

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Antithrombin, protein C and protein S levels in 127 consecutive young adults with ischemic stroke

Cited by 53 publications

References 28 publications

Role of Investigating Thrombophilic Disorders in Young Stroke

Role of Investigating Thrombophilic Disorders in Young Stroke

Antithrombin Cambridge II(A384S) mutation frequency and antithrombin activity levels in 120 of deep venous thrombosis and 150 of cerebral infarction patients in a single center in Southern China

Ischemic Stroke in Young due to Combined Protein C and S Deficiency

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