Hemianopsy revealing cerebral thrombosis: role of protein S deficiency induced by L-asparginase

BACKGROUND: Cerebral thrombosis associated with protein S deficiency is ver y rare and is mainly related to hereditary form of protein S deficiency CASE REPORT: A 19-year-old girl with acute lymphoblastic leukemia presented hemianopsy within a few days after the first administration of L-asparagin ase. Magnetic resonance of the brain showed a cortical infarct. A marked de crease of the level of protein S was documented. Few days later, the patien t was free of symptoms and protein S level was restored to the normal sugge sting that the cerebral thrombosis was caused by transient protein S defici ency induced by L-asparaginase administration. DISCUSSION: Patients with neurological complication caused by L-asparaginas e should be tested for protein S and other anticoagulant deficiencies.