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Annales de Biologie Clinique

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


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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
  • Key words: protein S antibodies, cerebral thrombophlebitis, varicella
  • DOI : 10.1684/abc.2011.0657
  • Page(s) : 99-103
  • Published in: 2012

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.