Protein S deficiency and retinal arteriolar occlusion in pregnancy.
OBJECTIVE
To report two cases of retinal arteriolar occlusion in pregnant women with transient protein S (PS) deficiency.


METHODS
Observational case reports.


RESULTS
Two pregnant women in their 30s presented with a paracentral scotoma in their right and left eye, respectively. In both cases the only risk factor for vascular occlusion was pregnancy. Systemic diseases were excluded. Free and functional PS activity was physiologically reduced in both patients. In Case 1, free PS was 47% and functional PS was 22%. In Case 2, free PS was 43% and functional PS was 25%. These levels of PS seem to be lower than those published for normal pregnancy.


CONCLUSIONS
There might be a special relationship between PS deficiency and the development of arterial occlusion in pregnant women. A direct effect may be possible. Although the prevalence and incidence of vasoocclusive disease in these patients are low, PS deficiency should be considered as another risk factor. Further studies are necessary to evaluate changes in PS and to assess its relationship with thromboembolic events during pregnancy.
Department of Ophthalmology, University of Barcelona, Hospital de Sant Pau y de la Santa Creu, Barcelona, Spain. 34128jvs@comb.es
J I
JI
Vela
J
J
Diaz-Cascajosa
J
J
Crespi
T
T
Mariages
J A
JA
Buil
D000328:Adult; D001160:Arterioles / Q000473:pathology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications; D017293:Protein S / Q000032:analysis; D018455:Protein S Deficiency / Q000150:complications* / Q000175:diagnosis; D015356:Retinal Artery Occlusion / Q000150:complications* / Q000175:diagnosis; D012307:Risk Factors; D012607:Scotoma / Q000175:diagnosis
D017293:Protein S