A Case of Unexplained Cerebral Sinus Thrombosis in a 22-Year-Old Obese Caucasian Woman.
Herein, we present the case of a 22-year old obese Caucasian woman female with no acquired thrombophilic risk factors who was diagnosed with extensive cerebral sinus thrombosis. A detailed thrombophilia workup demonstrated persistently elevated plasminogen activator inhibitor 1 (PAI-1) activity levels, with an elevated PAI-1 antigen concentration and homozygosity for the PAI-1 4G allele (4G/4G genotype). The patient was treated with indefinite warfarin anticoagulation medication due to the unprovoked nature of her thrombotic event. Disturbances in the fibrinolytic system, in particular PAI-1, have been related to an increased risk of arterial and venous thrombosis. In this article, we discuss the pathophysiology of hypofibrinolysis associated with elevated PAI-1 levels and the PAI-1 4G/5G polymorphism.
Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, seheultj@upmc.edu.
Jansen N
JN
Seheult
Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, Institute for Transfusion Medicine, University of Pittsburgh Medical Center Health System, Pittsburgh, PA.
Irina
I
Chibisov
D005260:Female; D005838:Genotype; D006257:Head / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D009765:Obesity / Q000150:complications*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood* / Q000235:genetics*; D012851:Sinus Thrombosis, Intracranial / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology*; D044465:White People; D055815:Young Adult
D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human
cerebral sinus thrombosis; gene promoter regions; hypofibrinolysis; plasminogen activator inhibitor 1; plasminogen inactivators; venous thrombosis