[Acquired protein C deficiency in ulcerative colitis. The cause of thromboembolic complications].
Three patients with an acute exacerbation of ulcerative colitis (a 40-year-old and a 31-year-old man and a 30-year-old woman) developed a protein C deficiency (serum protein C activity between 32 and 48%). In the two men the protein C deficiency was diagnosed only after the onset of severe thromboembolic complications (cavernous sinus thrombosis; pulmonary embolism) during heparin treatment. But in the woman protein C activity was measured immediately after hospital admission (in the knowledge of the first two cases) even before heparin administration was started. All three patients received treatment with sulphasalazine (3 g daily) and fluocortolone (60 mg daily), as well as full heparinization (22,500-36,000 IU daily). Protein C activity returned to normal on remission of the ulcerative colitis (in one case only after subtotal colectomy). These case reports show that acquired protein C deficiency can be reversed by rigorous treatment of the underlying disease.
Korsten
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Abteilung I, Krankenhaus Maria Hilf, Mönchengladbach.
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D000328:Adult; D003093:Colitis, Ulcerative / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D005448:Fluocortolone / Q000008:administration & dosage; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D008297:Male; D010288:Parenteral Nutrition; D011486:Protein C / Q000032:analysis; D020151:Protein C Deficiency; D012460:Sulfasalazine / Q000008:administration & dosage; D013923:Thromboembolism / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy
D011486:Protein C; D012460:Sulfasalazine; D005448:Fluocortolone; D006493:Heparin
Erworbener Protein-C-Mangel bei Colitis ulcerosa. Ursache thromboembolischer Komplikationen.