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Annales de Biologie Clinique

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Post-varicella cerebral thrombophlebitis with anti-protein S: report of a pediatric case Volume 70, issue 1, Janvier-Février 2012

Authors
Pôle de pédiatrie, Hôpital de Hautepierre, Strasbourg, Laboratoire d’hématologie, HUS, Hôpital de Hautepierre, Strasbourg, Hyphen Biomed SAS Research and Scientific Director, Service de pédiatrie, Hôpital de Sarreguemines

Purpura fulminans and venous thrombosis are rare complications of chickenpox. We report the case of a 6 year old with no history individuals who experienced cerebral thrombophlebitis, 3 weeks after varicella. MRI, performed at admission, has objectified longitudinal sinus thrombosis and a frontal parenchymal hematoma law. Meanwhile, a recent varicella seroconversion was demonstrated. The assessment of thrombophilia, meanwhile, has objectified a significant decrease in free protein S and activity, without associated DIC. Origin acquired this deficit was confirmed by the detection of antibodies (IgG and IgM) against the total protein S by ELISA. After evaluation of the benefit/risk only anticoagulation was initiated. The clinical and biological evolution was favorable, with rapid normalization of the S protein and decrease of anti-protein S. Many studies report the presence of anti-protein S in young children at the waning of chickenpox, without their exact frequency is determined. The decrease in protein S they cause leads to a transient hypercoagulable state may result in different clinical pictures. Cases of purpura fulminans seem more frequent when venous thrombosis isolated post chickenpox, sometimes atypical, appear rare.