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Multiple coagulation defects and the Cohen syndrome

T L Schlichtemeier1, G E Tomlinson, B A Kamen

  • 1Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas 75235-9063.

Clinical Genetics
|April 1, 1994
PubMed
Summary

Cohen syndrome, a rare genetic disorder, is linked to blood clotting issues and stroke in siblings. This case highlights the syndrome

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Area of Science:

  • Genetics
  • Neurology
  • Hematology

Background:

  • Cohen syndrome is an autosomal recessive disorder characterized by intellectual disability, hypotonia, and distinct facial features.
  • Genetic vasculopathies are conditions affecting blood vessels, often leading to thrombotic events like stroke.

Observation:

  • A 13-year-old male presented with seizures, sagittal sinus thrombosis, cerebral hemorrhage, and extensive lower limb venous thrombosis.
  • He and his sister exhibited dysmorphic features including microcephaly, unusual facies, Marfanoid habitus, and lax connective tissue.
  • Laboratory findings revealed combined deficiencies in protein C, protein S, and antithrombin III.

Findings:

  • The siblings were diagnosed with Cohen syndrome, a condition not previously associated with significant thrombotic events.

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  • The male sibling's severe thrombotic events (sagittal sinus thrombosis, intracranial hemorrhage, deep venous thrombosis) suggest a link between Cohen syndrome and genetic vasculopathies.
  • The combined deficiencies in coagulation factors (protein C, S, antithrombin III) likely predisposed the patient to thrombosis.
  • Implications:

    • This case expands the clinical spectrum of Cohen syndrome to include severe thrombotic complications and genetic vasculopathy.
    • It underscores the importance of considering thrombophilia in patients with Cohen syndrome, especially those presenting with neurological or vascular events.
    • Further research is warranted to elucidate the specific mechanisms linking Cohen syndrome to increased thrombotic risk and vasculopathy.