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Updated: Jul 24, 2026

Targeted Next-generation Sequencing and Bioinformatics Pipeline to Evaluate Genetic Determinants of Constitutional Disease
Published on: April 4, 2018
Homozygous protein C deficiency with delayed onset of symptoms at 7 to 10 months
E G Tuddenham1, T Takase, A E Thomas
1Haemostasis Research Group, Clinical Research Centre, Harrow, Middlesex, U.K.
Insights
Homozygous protein C deficiency presents unique challenges, with two cases showing intermediate severity. Early intervention with plasma or prothrombin complex, followed by Warfarin, proved effective for these patients.
Area of Science:
- Genetics
- Hematology
- Pediatrics
Background:
- Protein C deficiency is a rare inherited thrombophilia.
- Homozygous forms typically manifest in neonates with severe thrombotic events like purpura fulminans.
- Dominant and recessive forms exhibit distinct clinical presentations.
Abstract:
We report an inbred family with two cases of homozygous protein C deficiency and review 11 other such cases. Both patients presented in the second half of their first year of life with recurrent rapidly disappearing ecchymotic skin lesions, disseminated intravascular coagulation, and venous thrombosis. Successful treatment has been achieved by frequent infusions of plasma or prothrombin complex then maintained with Warfarin. Homozygous recessive protein C deficiency usually presents in the neonatal period with purpura fulminans. Two cases have been described elsewhere which presented in the second decade of life with milder symptoms. The present cases appear to be intermediate in time of presentation and severity of symptoms. We also review the distinction that is now evident between recessive and dominant protein C deficiency.
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