Sagittal sinus thrombosis associated with transient free protein S deficiency after L-asparaginase treatment: case report and review of the literature.

Abstract

Cerebral sinus thrombosis associated with acquired free protein S deficiency is very rare. We report the case of an adult patient with acute lymphoblastic leukemia who presented with repeated transient ischemic attacks followed by a seizure during consolidation treatment with L-asparaginase. Magnetic resonance of the brain showed a small cortical hemorrhagic infarct. Superior sagittal sinus thrombosis was demonstrated by cerebral angiogram. A marked decrease of the free form of protein S was documented. One month later, when the patient was free of symptoms, the follow-up free protein S antigen level was restored to the normal range. We suggest that the sagittal sinus thrombosis in this patient was caused by acquired, transient free protein S deficiency. This case also extends the clinical spectrum of cerebral sinus thrombosis to include recurrent transient ischemic attacks alternating with seizures.

• Authors: J H Lee, S W Kim, J Sung Kim
• Journal: Clinical neurology and neurosurgery (Clin Neurol Neurosurg) Vol. 102 Issue 1 Pg. 33-6 (Mar 2000) ISSN: 0303-8467 [Print] Netherlands
• PMID: 10717401 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Antineoplastic Agents
• Asparaginase

Topics

• Adult
• Antineoplastic Agents (adverse effects)
• Asparaginase (adverse effects)
• Cerebral Angiography (methods)
• Frontal Lobe (pathology)
• Humans
• Magnetic Resonance Imaging
• Male
• Paresis (diagnosis)
• Precursor Cell Lymphoblastic Leukemia-Lymphoma (drug therapy)
• Protein S Deficiency (chemically induced, complications)
• Sinus Thrombosis, Intracranial (diagnosis, etiology)