scholarly journals Seven Zoster Reactivations in an Immune Competent Patient: How Many Is Too Many?

2007 ◽  
Vol 2;10 (3;2) ◽  
pp. 301-304
Author(s):  
Rashid M. Rashid
Keyword(s):  
Herpes Zoster ◽  
Rare Case ◽  
Protein S ◽  
Clinical Implications ◽  
Protein S Deficiency ◽  
Post Herpetic Neuralgia ◽  
Management Options ◽  
Competent Patient ◽  
S Deficiency ◽  
Compromised Patients

Herpes zoster virus (HZV) reactivation is commonly reported in elderly or immune compromised patients. However, certain presentations are rarely reported in immune competent patients. Here we report a rare case of recalcitrant HZV infection, including 7 reactivations over 3 years, in an immune competent patient. Due to the pain experienced, this patient self-referred to our clinic, and thus bypassed other specialties. As pain management specialists, it is critical to be aware of such presentations, the clinical implications involved, and management options to consider. Key words: Zoster, herpes zoster, zoster reactivation, shingles, post-herpetic neuralgia, Protein S deficiency, epidural analgesia

scholarly journals Protein S Deficiency - An Uncommon Cause with Common Presentation

2016 ◽  
Vol 35 (2) ◽  
pp. 192-194
Author(s):  
Nabanita Kora ◽  
Rajib Das ◽  
Sabyasachi Som ◽  
Sumanta Laha ◽  
Nayan Bannerji ◽  
...  
Keyword(s):  
Health Problem ◽  
Rare Case ◽  
Protein S ◽  
Protein S Deficiency ◽  
Major Health Problem ◽  
Major Health ◽  
Young Stroke ◽  
Common Presentation ◽  
S Deficiency

Correction: The correct PDF for this article was loaded on 9th March 2017. We offer our sincere apologies for having the wrong PDF loaded for this article.Stroke in child poses a major health problem. Thrombophilic factors have been implicated in 4-8% of young stroke worldwide. Protein S deficiency is a very rare cause of stroke. A few cases have been reported in literature. We are reporting a rare case of protein S deficiency causing stroke in a two year old child.J Nepal Paediatr Soc 2015;35(2):192-194

Mesenteric Ischemia and Protein S Deficiency: A Rare Case Report

2010 ◽  
Vol 39 (5) ◽  
pp. 579-582 ◽  
Author(s):  
Ingrid Llovera ◽  
Zhanna Roit ◽  
Shadi Kiriaki ◽  
Andrew Sama ◽  
John Loscalzo ◽  
...  
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Mesenteric Ischemia ◽  
Protein S ◽  
Protein S Deficiency ◽  
S Deficiency ◽  
Rare Case Report

scholarly journals Deep venous thrombosis in a patient with therapeutic INR for PS deficiency

2017 ◽  
Vol 6 (1) ◽  
pp. 340
Author(s):  
Motahareh Vamegh ◽  
Ahmad Hallak ◽  
Wael Abousherif
Keyword(s):  
Case Report ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Rare Case ◽  
Protein S ◽  
Therapeutic Index ◽  
Medical Ward ◽  
Protein S Deficiency ◽  
Doppler Us ◽  
S Deficiency

We have reported a rare case of DVT in a 25-year-old patient with a known case of Protein S deficiency with INR within therapeutic index. He was seen in the ED and transferred to the Medical ward after diagnosis in the ED using doppler US. The patient was successfully treated with heparin and warfarin with a higher than usual optimal INR. This case adds to the growing evidence that PS deficiency is one of the rare causes of DVT, and also raises awareness that thrombosis can still occur in the current optimal INR for such patients. This case report necessitates the revision of what should be the optimal INR for patients with Protein S deficiency who develop thrombosis in the current optimal INR.

The Frequency of Type I Heterozygous Protein S and Protein C Deficiency in 141 Unrelated Young Patients with Venous Thrombosis

1988 ◽  
Vol 59 (01) ◽  
pp. 018-022 ◽  
Author(s):  
C L Gladson ◽  
I Scharrer ◽  
V Hach ◽  
K H Beck ◽  
J H Griffin
Keyword(s):  
Venous Thrombosis ◽  
Protein C ◽  
Antithrombin Iii ◽  
Young Patients ◽  
Protein S ◽  
Type I ◽  
Protein S Deficiency ◽  
Protein C Deficiency ◽  
Low Protein ◽  
S Deficiency

SummaryThe frequency of heterozygous protein C and protein S deficiency, detected by measuring total plasma antigen, in a group (n = 141) of young unrelated patients (<45 years old) with venous thrombotic disease was studied and compared to that of antithrombin III, fibrinogen, and plasminogen deficiencies. Among 91 patients not receiving oral anticoagulants, six had low protein S antigen levels and one had a low protein C antigen level. Among 50 patients receiving oral anticoagulant therapy, abnormally low ratios of protein S or C to other vitamin K-dependent factors were presented by one patient for protein S and five for protein C. Thus, heterozygous Type I protein S deficiency appeared in seven of 141 patients (5%) and heterozygous Type I protein C deficiency in six of 141 patients (4%). Eleven of thirteen deficient patients had recurrent venous thrombosis. In this group of 141 patients, 1% had an identifiable fibrinogen abnormality, 2% a plasminogen abnormality, and 3% an antithrombin III deficiency. Thus, among the known plasma protein deficiencies associated with venous thrombosis, protein S and protein C. deficiencies (9%) emerge as the leading identifiable associated abnormalities.

Severe Arterial Cerebral Thrombosis in a Patient with Protein S Deficiency (Moderately Reduced Total and Markedly Reduced Free Protein S): A Family Study

1989 ◽  
Vol 61 (01) ◽  
pp. 144-147 ◽  
Author(s):  
A Girolami ◽  
P Simioni ◽  
A R Lazzaro ◽  
I Cordiano
Keyword(s):  
Arterial Thrombosis ◽  
Protein C ◽  
Protein S ◽  
Protein S Deficiency ◽  
Protein C Deficiency ◽  
Free Protein ◽  
Her Family ◽  
S Deficiency ◽  
Increased Risk ◽  
Patient Reported

SummaryDeficiency of protein S has been associated with an increased risk of thrombotic disease as already shown for protein C deficiency. Deficiencies of any of these two proteins predispose to venous thrombosis but have been only rarely associated with arterial thrombosis.In this study we describe a case of severe cerebral arterial thrombosis in a 44-year old woman with protein S deficiency. The defect was characterized by moderately reduced levels of total and markedly reduced levels of free protein S. C4b-bp level was normal. Protein C, AT III and routine coagulation tests were within the normal limits.In her family two other members showed the same defect. All the affected members had venous thrombotic manifestations, two of them at a relatively young age. No other risk factors for thrombotic episodes were present in the family members. The patient reported was treated with ASA and dipyridamole and so far there were no relapses.

The Relationship between Plasma Microparticles, Protein S and Anticardiolipin Antibodies in Patients with Human Immunodeficiency Virus Infection

1996 ◽  
Vol 76 (01) ◽  
pp. 038-045 ◽  
Author(s):  
Jean-Christophe Gris ◽  
Pierre Toulon ◽  
Sophie Brun ◽  
Claude Maugard ◽  
Christian Sarlat ◽  
...  
Keyword(s):  
Poor Prognosis ◽  
Anticardiolipin Antibody ◽  
Protein S ◽  
Anticardiolipin Antibodies ◽  
Protein S Deficiency ◽  
Free Protein ◽  
Precipitation Technique ◽  
S Deficiency ◽  
Immunodeficiency Virus ◽  
Antibody Titers

SummaryThe high prevalence of free protein S deficiency in human immunodeficiency virus (HlV)-infected patients is poorly understood. We studied 38 HIV seropositive patients. Free protein S antigen values assayed using the polyethylene-glycol precipitation technique (PEG-fS) were statistically lower in patients than in controls. These values using a specific monoclonal antibody-based ELISA (MoAb-fS) and the values of protein S activity (S-act) were not statistically different between patients and controls. C4b-binding protein values were not different from control values. In patients, PEG-fS values were lower than MoAb-fS values. Ten patients had a PEG-fS deficiency, 4 patients had a MoAb-fS deficiency and 8 had a S-act deficiency. Protein S activity and MoAb-fS were lower in clinical groups with poor prognosis and in patients with AIDS but PEG-fS was not. A trend for reduced S-act/MoAb-fS ratios was observed in patients. PEG-fS was negatively correlated with anticardiolipin antibody titers whereas MoAb-fS was not. The plasma of PEG-fS deficient HIV-patients contained high amounts of flow cytometry detectable microparticles which were depleted from plasma by PEG precipitation. The microparticles were partly CD42b and CD4 positive but CD8 negative. These microparticles were labelled by an anti free protein S monoclonal antibody. The observed differences between MoAb-fS and PEG-fS values were correlated with the amount of detectable plasma microparticles, just like the differences between MoAb-fS and S-act. Plasma microparticles correlated with anticardiolipin antibody titers.In summary, free protein S antigen in HIV infected patients is underestimated when the PEG precipitation technique is used due to the presence of elevated levels of microparticles that bind protein S. The activity of free protein S is also impaired by high levels of microparticles. The prevalence of free protein S deficiency in HIV positive patients is lower than previously published (4/38, -10%) and is correlated with poor prognosis. By implication, use of a PEG precipitation technique might give artefactually low free protein S antigen values in other patient groups if high numbers of microparticles are present. In HIV patients, high titers of anticardiolipin antibodies are associated with high concentrations of cell-derived plasma microparticles.

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