Factor V Leiden and antibodies against phospholipids and protein S in a young woman with recurrent thromboses and abortion

We describe the case of a 39-year-old woman who suffered two iliofemoral ve nous thromboses, a cerebral ischemic infarct and recurrent fetal loss. Init ial studies showed high levels of antiphospholipid antibodies (APAs) and a moderate thrombocytopenia. After her second miscarriage, laboratory diagnos is revealed that the woman was heterozygous for the factor V Leiden mutatio n and had a functional protein S deficiency as well as anti-protein S and a nti-beta(2)-glycoprotein I antibodies. The impairment of the protein C path way at various points could well explain the recurrent thromboses in the pa tient and supports the role of a disturbed protein C system in the pathophy siology of thrombosis in patients with APAs. (C)1999, Ferrata Storti Founda tion.