title: Cerebral infarction in an HIV-infected patient with combined protein S and C deficiency and a patent foramen ovale.
abstract: A 41-year-old male with a history of human immunodeficiency virus (HIV) infection developed motor aphasia, dysarthria, and right hemiparesis. A magnetic resonance imaging scan of the brain revealed a cerebral infarction in the territory of the left middle cerebral artery. The laboratory data showed decreased levels of protein S and protein C. Transesophageal contrast-enhanced echocardiography revealed a patent foramen ovale (PFO). Prothrombotic states, such as protein S and C deficiency, have been reported in HIV-infected patients. In addition, previous studies have reported prothrombotic states to be risk factors for PFO-related cerebral infarction. An association between combined protein S and C deficiency caused by HIV infection and PFO-related cerebral infarction was suggested in our patient.
authors.affiliation: Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Ran
authors.initials: R
authors.lastname: Tomomasa
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yamashiro
authors.forename: Ryota
authors.initials: R
authors.lastname: Tanaka
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Hattori
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001780:Blood Coagulation Tests; D038524:Diffusion Magnetic Resonance Imaging; D017548:Echocardiography, Transesophageal; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D011237:Predictive Value of Tests; D020151:Protein C Deficiency / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D018455:Protein S Deficiency / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D012307:Risk Factors
chemical_list: D000925:Anticoagulants
keywords: Cerebral infarction; human immunodeficiency virus; patent foramen ovale; protein C deficiency; protein S deficiency