Ischemic Stroke with Protein S Deficiency Treated by Apixaban
Ischemic Stroke with Protein S Deficiency Treated by Apixaban
复制标题
DOI：
10.1016/j.jstrokecerebrovasdis.2019.104608
复制
发表时间：
2020-04-01
影响因子：
2.5
通讯作者：
Yasaka, Masahiro
中科院分区：
文献类型：
--
作者：
Ohashi, Ikkei;Wada, Shinichi;Yasaka, Masahiro
一名 57 岁男性患有动脉粥样硬化闭塞症，因突发感觉性失语和右侧偏瘫入院。脑部核磁共振显示左颞叶急性脑梗塞，磁共振血管造影显示左大脑中动脉后支闭塞。经食管超声心动图和超声检查分别证实卵圆孔未闭和双侧股静脉深静脉血栓。血液检查结果显示蛋白 S 抗原低、蛋白 S 活性低以及 PROS 1 基因错义突变。阿哌沙班 10 mg BID 的给药可预防缺血性中风复发并减少深静脉血栓形成。这些结果表明，阿哌沙班可以替代华法林，用于蛋白质 S 缺乏患者的缺血性中风的二级预防。
A 57-year-old man with atherosclerosis obliterans was admitted with sudden-onset sensory aphasia and right hemiparesis. Brain MRI revealed acute cerebral infarctions in the left temporal lobe and magnetic resonance angiography showed occlusion of the posterior branch of the left middle cerebral artery. Transesophageal echocardiography and ultrasonography respectively confirmed a patent foramen ovale and deep vein thrombosis in the bilateral femoral veins. Blood findings showed low protein S antigen, low protein S activity, and a missense mutation of the PROS 1 gene. The administration of apixaban 10 mg BID prevented ischemic stroke recurrence and decreased the deep vein thrombosis. These outcomes indicated that apixaban may be alternative to warfarin for the secondary prevention of ischemic stroke in a patient with a protein S deficiency.