Klin Padiatr 2010; 222(3): 194-195
DOI: 10.1055/s-0030-1249066
Pictorial Essay

© Georg Thieme Verlag KG Stuttgart · New York

Compound Heterozygosity of the Protein S-Gene as a Cause of Severe Cerebral Sinovenous Thrombosis in a 7-Year-Old Child

Compound-heterozygote Mutationen des Protein-S-Gens als Ursache für eine Sinusvenenthrombose bei einem 7-jährigen MädchenI. Hainmann1 , R. Korinthenberg2 , J. Oldenburg3 , A. Pavlova3 , I. Mader4 , B. Zieger1
  • 1University Medical Center Freiburg, Department of Paediatrics and Adolescent Medicine, Freiburg, Germany
  • 2University Medical Center Freiburg, Department of Paediatrics and Adolescent Medicine, Clinic II: Neuropediatrics and Muscle Diseases, Freiburg, Germany
  • 3University Clinic Bonn, Instritute of Experimental Haematology and Transfusion Medicine, Bonn, Germany
  • 4University Medical Center Freiburg, Department of Neuroradiology, Freiburg, Germany
Further Information

Publication History

Publication Date:
31 May 2010 (online)

Abstract

The genotype-phenotype relationship of compound heterozygous protein S-deficiency in a 7-year-old girl with reduced protein S-levels and a severe cerebral sinovenous thrombosis is illustrated. In this patient we identified a novel deletion in the protein S-gene causing a compound heterozygous state and subsequently a symptomatic protein S-deficiency. In case of thrombosis analysis of protein S is recommended. Low levels of protein S should be further investigated by molecular diagnostics.

Zusammenfassung

Dieser Artikel charakterisiert das Verhältnis von Genotyp zu Phänotyp bei Compound-heterozygotem Protein-S-Mangel bei einem Mädchen mit schwerer Sinusvenenthrombose und Protein-S-Mangel. Wir wiesen eine bisher unbekannte Deletion im Protein-S-Gen nach, die zu einer Compound-Heterozygotie und somit zu einem symptomatischen Protein-S-Mangel führte. Im Falle einer Thrombose wird die Bestimmung von Protein S empfohlen; wiederholt niedrige Werte für Protein S können molekulargenetisch abgeklärt werden.

References

  • 1 Bernbeck B, Wüller D, Janssen G. et al . Symptoms of childhood acute lymphoblastic leukemia: red flags to recognize leukemia in daily practice.  Klin Pädiatr. 2009;  221 369-373
  • 2 Duchemin J, Gandrille S, Borgel D. et al . The Ser 460 to Pro substitution of the protein S alpha (PROS1) gene is a frequent mutation associated with free protein S (type IIa) deficiency.  Blood. 1995;  86 3436-3443
  • 3 Ege MJ, Meyer LH, Debatin KM. et al . Coincidence of recurrent hemiparesis and detection of ALL in a 4-year-old girl: one or two diseases?.  Klin Pädiatr. 2009;  221 386-389
  • 4 Heller C, Heinecke A, Junker R. et al . Cerebral venous thrombosis in children: A multifactorial origin.  Circulation. 2003;  108 1362-1367
  • 5 Kenet G, Kirkham F, Niederstadt T. et al . Risk factors for recurrent venous thromboembolism in the European collaborative paediatric database on cerebral venous thrombosis: a multicentre cohort study.  Lancet Neurol. 2007;  6 595-603
  • 6 Monagle P, Chan A, Massicotte P. et al . Antithrombotic therapy in children: The seventh ACCP conference on antithrombotic and thrombolytic therapy.  Chest. 2004;  126 645-687
  • 7 Nowak-Göttl U, Junker R, Kreuz W. et al . Risk of recurrent venous thrombosis in children with combined prothrombotic risk factors.  Blood. 2001;  97 858-862
  • 8 Nowak-Göttl U, Kurnik K, Krümpel A. et al . Thrombophilia in the young.  Hamostaseologie. 2008;  28 16-20

Correspondence

Dr. Ina Hainmann

University Medical Center Freiburg

Department of Paediatrics and Adolescent Medicine

Mathildenstraße 1

79106 Freiburg

Germany

Phone: +49/761/270 4300

Fax: +49/761/270 4616

Email: ina.hainmann@uniklinik-freiburg.de

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