PROTEIN C AND S DEFICIENCY IN ACUTE MESENTERIC ISCHAEMIA: A CASE REPORT

Shailata Prisi, MBBS, *Elvia Jamatia, MBBS, Shweta Priti, MBBS, Harshit Kelkar, MBBS and Binita Goswami, MBBS

ABSTRACT

Protein C and Protein S are vitamin K dependent plasma proteins which are important as anticoagulants. So their deficiency predisposes to conditions associated with increased risk of thrombosis. We present a case of a 50yrs old male presented with abdominal pain in emergency. Provisional diagnosis of acute mesenteric ischaemia was made and patient underwent exploratory laparotomy with subtotal colectomy and ileostomy. Radiological investigations were suggestive of intestinal obstruction Blood investigation showed d-dimer >5000ng/ml, protein C- 62.7% and protein S- 67.7%. Protein S binds and assists activated protein C in the degradation of coagulation factors, therefore their deficiency leads to hypercoagulable state increasing the risk of thromboembolism events. One of these includes acute mesenteric ischaemia; a rare but life threatening condition. Early diagnosis is crucial in such cases for the prompt treatment to improve prognosis and avoid fulminant bowel necrosis.

Keywords: Protein C, Protein S, Thromboembolic events, Acute mesenteric ischaemia.