Recurrent venous thrombosis during direct oral anticoagulant therapy in a patient with protein S deficiency

Yagi, Shusuke; Kagawa, Kumiko; Fujimoto, Eiki; Sata, Masataka

doi:10.2152/jmi.66.182

Cited by 9 publications

(11 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 15 ] Some clinical reports have found that a standard dosage of new anti-coagulants showed less favorable results in treating CVST due to protein S deficiency, but satisfactory results were attained by increasing the dosage. [ 16 ] The use of new anti-coagulants in treating inherited thrombophilia remains controversial, and more studies are necessary.…”

Section: Discussionmentioning

confidence: 99%

Successful endovascular therapy for an adolescent patient with cerebral venous sinus thrombosis

Peng

Zhang

et al. 2021

Medicine

View full text Add to dashboard Cite

Rationale: Cerebral venous sinus thrombosis associated with protein S deficiency is rare in adolescent patients and has high disability and fatality. Patient concerns: A 15-year-old male student presented in the hospital with sudden headache, nausea, and vomiting and was diagnosed with protein S deficiency by gene testing. Diagnoses: Cerebral venous sinus thrombosis due to protein S deficiency was diagnosed in this adolescent patient, who underwent successful endovascular therapy (EVT). Interventions: The patient was treated with standard anti-coagulation therapy including low-molecular-weight heparin (90 IU/kg/Q12 h) and dehydrant (mannitol 125 mL Q8 h); however, the symptoms were not alleviated. Successful EVT was implemented. Outcomes: Both the superior sagittal sinus and bilateral transverse sinus were recanalized after thrombus clearance. The patient achieved a complete recovery without any other stroke recurrence during follow-up. Lessons: EVT can be performed with favorable and effective clinical outcomes in adolescent cerebral venous sinus thrombosis patients with protein S deficiency. EVT associated with standard anti-coagulation therapy may improve the prognosis and reduce mortality among such patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Successful endovascular therapy for an adolescent patient with cerebral venous sinus thrombosis

Peng

Zhang

et al. 2021

Medicine

View full text Add to dashboard Cite

show abstract

“…Cook et al [27] AT deficiency Rivaroxaban Rivaroxaban effective in preventing recurrent VTE after hip fracture surgery Menon et al [28] Protein C deficiency Rivaroxaban Rivaroxaban safe and effective in a child with warfarin induced skin necrosis. Yagi et al [29] Protein S deficiency Edoxaban Recurrence of VTE attributed to non-adherence. Sakai et al [30] AT deficiency Edoxaban Successful treatment and prevention of VTE after extensive femoral-inferior vena cava thrombosis with PE treated by pregnancy interruption and Edoxaban.…”

Section: Discussionmentioning

confidence: 99%

“…Yagi et al, reported a 70-year-old man with unprovoked venous thromboembolism, known for poor adherence, treated with edoxaban. He developed an inferior vena cava thrombosis, was diagnosed with Protein S deficiency and successfully switched to high dose apixaban therapy thereafter [29].…”

Section: Efficacy Of Doacs In High Risk Ct (At Pc Ps Compound/ Hommentioning

confidence: 99%

Diagnosis and management of congenital thrombophilia in the era of direct oral anticoagulants

Alameddine

Nassabein

Gal

et al. 2020

Thrombosis Research

View full text Add to dashboard Cite

“…Several case reports have described patients who presented with VTE in the context of severe thrombophilia, such as PS deficiency, and were successfully treated with edoxaban [68,69] or rivaroxaban [70][71][72][73][74]; PC deficiency successfully treated with rivaroxaban [75,76] or edoxaban [77,78]; AT deficiency successfully treated with apixaban [79] or rivaroxaban [80]; homozygous FVL mutation successfully treated with rivaroxaban [81]; or double heterozygous FVL and F2 c.*97G>A mutations successfully treated with apixaban [82]. One case of a patient with severe hypofibrinogenemia successfully treated with rivaroxaban shows how challenging therapeutic management can become during the perioperative period [83].…”

Section: Place Of Doac For the Treatment Of Vtd In Patients With Inhe...mentioning

confidence: 99%

Inherited Thrombophilia in the Era of Direct Oral Anticoagulants

Khider

Gendron

Mauge

2022

IJMS

View full text Add to dashboard Cite

Severe inherited thrombophilia includes rare deficiencies of natural anticoagulants (antithrombin and proteins C and S) and homozygous or combined factor V Leiden and FII G20210A variants. They are associated with a high thrombosis risk and can impact the duration of anticoagulation therapy for patients with a venous thromboembolism (VTE) event. Therefore, it is important to diagnose thrombophilia and to use adapted anticoagulant therapy. The widespread use of direct anticoagulants (DOACs) for VTE has raised new issues concerning inherited thrombophilia. Concerning inherited thrombophilia diagnosis, DOACs are directed toward either FIIa or FXa and can therefore interfere with coagulation assays. This paper reports DOAC interference in several thrombophilia tests, including the assessment of antithrombin, protein S, and protein C activities. Antithrombin activity and clot-based assays used for proteins C and S can be overestimated, with a risk of missing a deficiency. The use of a device to remove DOACs should be considered to minimize the risk of false-negative results. The place of DOACs in the treatment of VTE in thrombophilia patients is also discussed. Available data are encouraging, but given the variability in thrombosis risk within natural anticoagulant deficiencies, evidence in patients with well-characterized thrombophilia would be useful.

show abstract

Recurrent venous thrombosis during direct oral anticoagulant therapy in a patient with protein S deficiency

Cited by 9 publications

References 22 publications

Successful endovascular therapy for an adolescent patient with cerebral venous sinus thrombosis

Successful endovascular therapy for an adolescent patient with cerebral venous sinus thrombosis

Diagnosis and management of congenital thrombophilia in the era of direct oral anticoagulants

Inherited Thrombophilia in the Era of Direct Oral Anticoagulants

Contact Info

Product

Resources

About