Charles D. Bolan, MD; Chitra Krishnamurti, PhD; Douglas B. Tang, PhD; Leonthena R. Carrington, BS; Barbara M. Alving, MD
A single kindred in North America with venous thrombosis was described as having defective fibrinolysis because of increased levels of plasminogen activator inhibitor-1 (PAI-1). Our study describes the discovery of protein S deficiency in this kindred and its association with venous thromboembolism.
A family study.
Twenty-eight adults (ages 21 to 71 years) from three generations of the kindred; seven had a history of venous thromboembolism.
Plasma levels of total and free protein S antigen, as well as the activities of protein S, protein C, PAI-1, and antithrombin III.
Six of 7 persons (86%) with a history of venous thromboembolism were deficient in total and free protein S; of 21 asymptomatic members, 9 were deficient in protein S (P = 0.08). When compared with these 9 asymptomatic family members, the 6 persons with protein S deficiency and a history of thrombosis tended to smoke (P = 0.01) and to have higher triglyceride levels (P = 0.001). Overall, the mean PAI-1 activity in the 7 persons who had thrombosis was 7.9 kAU/L (AU/mL) and was 9.3 kAU/L (AU/mL) in the 21 persons who did not have thrombosis (95% CI, 9.9 to 7.0).
In this kindred, a deficiency of total and free or functional protein S is the cause of thrombosis. Measurement of PAI-1 activity was not useful in the evaluation of familial thrombosis. The utility of the routine measurement of PAI-1 activity in the evaluation of familial thrombosis has not been established.
Bolan CD, Krishnamurti C, Tang DB, Carrington LR, Alving BM. Association of Protein S Deficiency with Thrombosis in a Kindred with Increased Levels of Plasminogen Activator Inhibitor-1. Ann Intern Med. ;119:779–785. doi: 10.7326/0003-4819-119-8-199310150-00002
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Published: Ann Intern Med. 1993;119(8):779-785.
Coagulopathies, Hematology/Oncology, Venous Thromboembolism.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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