PROTEIN C AND PROTEIN S DEFICIENCY IN THROMBOGENIC EVENTS

Thrombophilia is a disorder characterized by an increased incidence of venous and arterial thrombosis. It may be hereditary or acquired. Protein C and Protein S deficiency with or without high Homocysteine levels have been reported to be associated with thrombogenic events. AIM: To find protein C, protein S deficiency and hyperhomocysteinemia as the risk factors for thrombogenic events through a retrospective analysis of patients admitted in the medicine department with thrombogenic events over a period of 1 year were evaluated. MATERIALS AND METHODS: Total 15 patients with thrombogenic events were reviewed for the demographic data, history, clinical findings and investigation reports. The data analyzed to find the risk factors associated. Protein C, Protein S and Homocysteine levels were evaluated on a fully automated coagulometer. Acquired causes of were excluded. RESULTS: Average age of the patient was 31.8 years with male predominance in 67%. Thrombogenic events was mainly in the form of cerebrovascular accidents in 40% (6 of 15) patients and deep vein thrombosis in 26.7 %( 4 of 15) patients. Protein C deficiency occurred in 46.7% (7of 15) patients, while Protein S deficiency in 86.7 %( 13 of 15) patients. Combined Protein C and S deficiency occurred in 40% (6 of 15) patients. Hyperhomocysteinaemia was documented as a predisposing factor in 26.7 %( 4 of 15) patients. CONCLUSION: We conclude that, the frequency of protein C deficiency, protein S deficiency and hyperhomocysteinemia are significantly higher among those with thrombogenic events than general population and hence need to be screened for in all thrombogenic events. INTRODUCTION: Thrombophilia is a disorder characterized by an increased incidence of venous and arterial thrombosis. It may be hereditary and conferred by genes inherited from one or more parents, or it may be acquired through situations such as surgery, cancer, pregnancy, or certain medications (eg, some contraceptive and menopausal hormone replacement products). The two most common hereditary thrombophilia conditions are the factor V Leiden and prothrombin 20210 gene mutations. [1,2] Protein C and Protein S deficiency with or without high Homocysteine levels have been reported to be associated with thrombogenic events. Hence, a retrospective study of thrombogenic events in patients admitted in medicine department was done to find protein C, protein S deficiency and Homocysteine levels as associated risk factors for the same. AIM: To find protein C, protein S deficiency and hyperhomocysteinemia as the risk factors for thrombogenic events among patients admitted in medicine department. Design: A retrospective analysis of 15 cases admitted in the medicine department of teaching institute with thrombogenic events over a period of 1 year were evaluated for inherited thrombogenic disorders.