Hypercoagulability and Cavernous Sinus Thrombosis due to Protein C Deficiency. A Case Report.

Background: Thrombophilia due to protein C deficiency is an unusual condition, present in 0.2% of general population. Cerebral venous thrombosis has an incidence of 3-4 cases per million in adults. A combination of both is very uncommon. Patients with these conditions are prone to acquiring life-th...

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Main Authors: Wilson S. Peñafiel-Pallares, Camila Brito-Balanzátegui
Format: Article
Language:English
Published: University Library System, University of Pittsburgh 2022-12-01
Series:International Journal of Medical Students
Subjects:
Online Access:https://ijms.info/IJMS/article/view/1751
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author Wilson S. Peñafiel-Pallares
Camila Brito-Balanzátegui
author_facet Wilson S. Peñafiel-Pallares
Camila Brito-Balanzátegui
author_sort Wilson S. Peñafiel-Pallares
collection DOAJ
description Background: Thrombophilia due to protein C deficiency is an unusual condition, present in 0.2% of general population. Cerebral venous thrombosis has an incidence of 3-4 cases per million in adults. A combination of both is very uncommon. Patients with these conditions are prone to acquiring life-threatening superinfections. Case: A 51-year-old woman presented to the Emergency Department with bilateral pressing frontal headache accompanied with nausea and vomiting. Laboratory findings, medical history and physical examination were unremarkable. Computed tomography demonstrated sphenoidal rhinosinusitis. Migraine diagnosis was established and treated with analgesics. No treatment for sphenoidal rhinosinusitis was prescribed. Over the next 2 weeks, headaches worsened, and the patient returned to the Emergency Department showing left periorbital edema, fever, diplopia, and disorientation. Laboratory exams showed low protein C levels, elevated procalcitonin and neutrophilia. Magnetic Resonance Venography revealed cavernous sinus thrombosis. The patient was treated with empiric antibiotic treatment (vancomycin, ceftriaxone, and metronidazole) and long-term direct oral anticoagulants (Dabigatran). After one year of the diagnosis, the patient fully recovered and showed no recurrence of thrombotic events.  Conclusion: This case report emphasizes the importance of early diagnosis and appropriate management of patients with protein C deficiency complicated by septic cavernous sinus thrombosis.
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spelling doaj.art-e3106d141f2d440ba9fd81976831848c2023-09-02T10:44:12ZengUniversity Library System, University of PittsburghInternational Journal of Medical Students2076-63272022-12-0110.5195/ijms.2022.1751Hypercoagulability and Cavernous Sinus Thrombosis due to Protein C Deficiency. A Case Report. Wilson S. Peñafiel-Pallares0Camila Brito-Balanzátegui1Universidad de las Américas A00035440Universidad de las Americas A00075221 Background: Thrombophilia due to protein C deficiency is an unusual condition, present in 0.2% of general population. Cerebral venous thrombosis has an incidence of 3-4 cases per million in adults. A combination of both is very uncommon. Patients with these conditions are prone to acquiring life-threatening superinfections. Case: A 51-year-old woman presented to the Emergency Department with bilateral pressing frontal headache accompanied with nausea and vomiting. Laboratory findings, medical history and physical examination were unremarkable. Computed tomography demonstrated sphenoidal rhinosinusitis. Migraine diagnosis was established and treated with analgesics. No treatment for sphenoidal rhinosinusitis was prescribed. Over the next 2 weeks, headaches worsened, and the patient returned to the Emergency Department showing left periorbital edema, fever, diplopia, and disorientation. Laboratory exams showed low protein C levels, elevated procalcitonin and neutrophilia. Magnetic Resonance Venography revealed cavernous sinus thrombosis. The patient was treated with empiric antibiotic treatment (vancomycin, ceftriaxone, and metronidazole) and long-term direct oral anticoagulants (Dabigatran). After one year of the diagnosis, the patient fully recovered and showed no recurrence of thrombotic events.  Conclusion: This case report emphasizes the importance of early diagnosis and appropriate management of patients with protein C deficiency complicated by septic cavernous sinus thrombosis. https://ijms.info/IJMS/article/view/1751ThrombophiliaProtein C DeficiencyCavernous sinus thrombosisCase report
spellingShingle Wilson S. Peñafiel-Pallares
Camila Brito-Balanzátegui
Hypercoagulability and Cavernous Sinus Thrombosis due to Protein C Deficiency. A Case Report.
International Journal of Medical Students
Thrombophilia
Protein C Deficiency
Cavernous sinus thrombosis
Case report
title Hypercoagulability and Cavernous Sinus Thrombosis due to Protein C Deficiency. A Case Report.
title_full Hypercoagulability and Cavernous Sinus Thrombosis due to Protein C Deficiency. A Case Report.
title_fullStr Hypercoagulability and Cavernous Sinus Thrombosis due to Protein C Deficiency. A Case Report.
title_full_unstemmed Hypercoagulability and Cavernous Sinus Thrombosis due to Protein C Deficiency. A Case Report.
title_short Hypercoagulability and Cavernous Sinus Thrombosis due to Protein C Deficiency. A Case Report.
title_sort hypercoagulability and cavernous sinus thrombosis due to protein c deficiency a case report
topic Thrombophilia
Protein C Deficiency
Cavernous sinus thrombosis
Case report
url https://ijms.info/IJMS/article/view/1751
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AT camilabritobalanzategui hypercoagulabilityandcavernoussinusthrombosisduetoproteincdeficiencyacasereport