Topics:
Medical Oncology • Hematology • Benign Hematology • Hemostasis/Thrombosis • Neurology • Vascular Neurology
How would you approach protein S deficiency found on hypercoagulability work-up in a patient with a post-operative central retinal vein occlusion?
In the setting of no personal or family history and no other risk factors for thrombosis, is systemic anticoagulation warranted if local treatments (e.g. intraocular bevacizumab) are successful? If so, for how long?
Answer from: at Academic Institution
I agree with Dr. @Louis M. Aledort's approach. A few caveats: 1) protein S deficiency is probably one of the most commonly misdiagnosed thrombophilia. Several variables affect the protein S activity assay, the antigen assays are more reliable but also affected by several variables (e.g. vitamin K de...
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Answer from: Medical Oncologist at Community Practice
1. Inc incidence of postpartum intracranial dural sinus venous thromboses particularly in S Asians that I saw.
2. Diagnosis tricky be careful about methodology (testing platform), many nuances must understand the testing methodology. Can have multiple prothrombotic mutations, sometimes ameliorated ...
Answer from: Medical Oncologist at Community Practice
Echoing the sentiments, below, I think the primary question is how one determines a patient has "protein s deficiency". Protein S antigen fluctuates with a number of physiologic conditions, and the presence of a low S activity level is not necessarily indicative of an inherited thrombophilia. S...
Answer from: at Academic Institution
Protein S deficiency is one of the most prothrombotic deficiencies. Retinal thrombosis may be the beginning of more serious thrombosis, therefore, lifelong anticoagulation. On Coumadin RX forever with INR 1.5 to 2. This is from my long experience.
Comments
Medical Oncologist at Ironwood Cancer & Research Center
Can DOACs be used in Protein S deficiency?
Can DOACs be used in Protein S deficiency?
at Mount Sinai
No good data.
No good data.
Medical Oncologist at Community Physicians Oncology
What about BRVO with Factor V heterozygous mutatio...
What about BRVO with Factor V heterozygous mutatio...