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Cerebral infarction associated with protein C deficiency
K Matsushita1, Y Kuriyama, T Sawada
1Department of Medicine, National Cardiovascular Center, Osaka, Japan.
Stroke
|January 1, 1992
Summary
A young woman experienced a stroke due to protein C deficiency, potentially caused by a combination of inherited and acquired factors, including chemotherapy. This highlights the link between protein C deficiency and thromboembolic events.
Area of Science:
- Hematology
- Neurology
- Oncology
Background:
- Protein C deficiency, both hereditary and acquired, is a known cause of thromboembolic disease.
- Antineoplastic agents can induce acquired protein C deficiency by interfering with vitamin K metabolism.
- Acquired protein C deficiency can lead to serious complications like cerebral infarction.
Observation:
- A young woman with protein C deficiency presented with sudden onset cerebral infarction.
- Her plasma protein C level was 38% upon admission.
- She had a history of stage II breast cancer treated with fluorouracil derivatives for 3 years.
- Her mother exhibited reduced plasma protein C activity, suggesting an inherited component.
Findings:
- Cerebral angiography showed occlusion of the right middle cerebral artery, which later recanalized.
- The patient's protein C deficiency was likely influenced by both inherited and acquired factors.
- Chemotherapy (fluorouracil derivatives) may have contributed to the acquired protein C deficiency.
Implications:
- This case suggests a potential interaction between inherited and acquired factors in inducing protein C deficiency.
- Understanding these interactions is crucial for managing thromboembolic risk in patients with cancer and protein C deficiency.
- Further research is needed to elucidate the mechanisms linking chemotherapy, protein C deficiency, and stroke.