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Protein S deficiency presenting as deep vein thrombosis--a case report
Ashwinikumar A Khandekar1, Sunita D Kumbhalkar, Harsha R Salkar
1Department of Medicine, Government Medical College and Hospital, Nagpur (M.S.), India. dr_ashwinikumar@rediffmail.com
Angiology
|October 21, 2003
Summary
This case study presents a rare instance of spontaneous bilateral internal jugular vein thrombosis in a young man. The condition, linked to Protein S deficiency, was successfully managed with conservative treatment and aspirin.
Area of Science:
- Vascular Medicine
- Hematology
Background:
- Internal jugular vein (IJV) thrombosis is uncommon, especially when spontaneous and bilateral.
- Risk factors typically include infection, malignancy, or interventions, which were absent in this case.
Observation:
- A 30-year-old male presented with facial, neck, and upper limb swelling after using non-padded crutches.
- CT imaging revealed bilateral IJV thrombosis extending to the superior vena cava.
Findings:
- Laboratory tests indicated Protein S deficiency (30.3%) and elevated fibrinogen (450 mg%).
- Protein C and antithrombin III levels were within normal limits.
Implications:
- This case highlights that bilateral IJV thrombosis can occur spontaneously due to inherited thrombophilias like Protein S deficiency.
- Conservative management with anticoagulation (aspirin) can lead to favorable outcomes.
- Early diagnosis allows for vigilant monitoring and timely management of potential complications.