Deficiency of Protein S and Factor V Presenting As Ischemic Stroke in A 14 Years Old Boy

A 14yearoldnondiabetic,nonhypertensiveboywasadmittedwithleftsidedhemiparesis.He hasbeendiagnosedwithischemicstrokeduetocombineddeficiencyofproteinSandfactorV.Inheritedthrombophiliadue todeficiencies ofnaturalanticoagulants (antithrombin,proteinC andproteinS)andactivatedproteinC resistance(APC-R)aremorecommonly associatedwithvenousratherthanarterialthrombosis.Whiledeficiency offactorV leadstoheamorrhage,somemutationslikefactorV Leidenpredisposeforthrombosis.Combined deficiencyofbothproteinC andfactorV leadingtoarterialthrombo-embolismcausingischemicstrokeisa rarerevent.