HEREDITARY PROTEIN-DEFICIENCY AND STROKE - 2 CASES

Herediatary protein S deficiency (HSPD) is a predisposing factor to re current venous thrombosis but is not currently associated with stroke. We report two cases of HSPD revealed by stroke in young adults. The f irst one was a 36-year-old patient whith a pure motor hemiplegia, who gradually recovered without sequelae. Total and free protein S was dec reased (55 and 10%). One of his brothers died from pulmonary embolism at 20 years and a sister had low protein S level without clinical sign s. The second case was a 26-year-old patient who had a right hemiplegi a with aphasia due to an infarction in middle cerebral artery area. He partially recovered, but the course of the illness was complicated by deep venous thrombosis of the lower limbs and pulmonary embolism. Tot al and free serum protein S level was severely decreased (25 and 0%). The patient's mother and one of his sisters also had low protein S but never had clinical complications. In both case, dupplex scanning, tra nscranial doppler, echocardiography, serum antithrombin III and protei n C were normal. Cigarette smoking was the only risk factor for arteri al disease. These two cases suggest that HSPD must be investigated in young patients with stroke, even in cases of lacunar stroke.