title: Prekallikrein deficiency presenting as recurrent cerebrovascular accident: case report and review of the literature.
abstract: We report the case of a woman with history of hypertension and hyperlipidemia presenting with recurrent episodes consistent clinically with cerebrovascular accidents (CVA), and MRI changes suggestive of ischemia versus vasculitis as their cause. No anatomical neurological, rheumatic, cardioembolic, or arteriosclerotic etiologies could be determined by extensive workup. Incidentally, the patient was found to have prolonged activated Partial Thromboplastin Time (aPTT) and a normal Prothrombin Time (PT); further testing revealed a prekallikrein deficiency. Since no other cause for the CVAs was established, and other prothrombotic states were ruled out, it is proposed that they are clinical manifestations derived from the prekallikrein deficiency, which in a patient with known cardiovascular risk factors could lead to thrombotic complications such as stroke.
authors.affiliation: Division of Hematology and Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1475 NW 12th Ave Suite 3300, Miami, FL 33136, USA.
authors.forename: Esteban Uribe
authors.initials: EU
authors.lastname: Bojanini
authors.forename: Arturo
authors.initials: A
authors.lastname: Loaiza-Bonilla
authors.forename: Agustin
authors.initials: A
authors.lastname: Pimentel