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Abstract
SummaryBeçget syndrome is a multisystem disorder characterized by ocular, mucocutaneous, articular, gastrointestinal and neurologic abnormalities. We report here an unusual case of Beçget syndrome, characterized by the importance of the thrombotic events(7 phlebitis of both legs and resection of two toes). Additional manifestations of the Beçget syndrome occurred only 10 years after the first thrombotic episode. The oldest daugther of the propositus and his brother suffered also from thrombophlebitis; this familial history of thrombosis led to the performance of a haemostatic study. A congenital protein S deficiency was found in the propositus and in three of his children. Normal protein S levels were found in nine unrelated patients with Beçget syndrome. Thus this observation suggests that, when thrombotic manifestations are the first and major symptom of Beçget syndrom, an additional cause of thrombosis has to be investigated.
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Affiliation(s)
- O Chafa
- CTS, Service de Médecine, C.H.U. Mustapha, Alger, Algérie
| | - A M Fischer
- Laboratoire d’Hématologie, C.H.U. Necker-Enfants Malades, Paris, France
| | - F Meriane
- CTS, Service de Médecine, C.H.U. Mustapha, Alger, Algérie
| | - T Chellali
- CTS, Service de Médecine, C.H.U. Mustapha, Alger, Algérie
| | - C Sternberg
- Laboratoire d’Hématologie, C.H.U. Necker-Enfants Malades, Paris, France
| | - F Otmani
- CTS, Service de Médecine, C.H.U. Mustapha, Alger, Algérie
| | - M Benabadji
- CTS, Service de Médecine, C.H.U. Mustapha, Alger, Algérie
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Fischer AM, Cornu P, Sternberg C, Mériane F, Dautzenberg MD, Chafa O, Beguin S, Desnos M. Antithrombin III Alger: A New Homozygous AT III Variant. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1661525] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryA qualitative abnormality of antithrombin III (AT III) was found in the plasma of a 41-year old patient. The plasmatic AT III antigen concentration was 130% and the progressive anti-F IIa and anti-F Xa activities were normal (105% and 137%). The plasma heparin cofactor activity was less than 10%, when measured by F Ila or F Xa inhibition. Crossed immunoelectrophoresis of AT III in the presence of heparin revealed in the plasma an abnormal slow-moving peak. When tested by affinity chromatography on heparin Sepharose, this abnormal AT III did not bind to heparin. Among the investigated relatives, 5 subjects had normal AT III levels, whatever the test used, the nine others having reduced levels of antithrombin heparin cofactor activity (45-61%) but normal levels of immunoreactive AT III (97-122%). Consanguinity was found in the family history. We therefore considered our patient as homozygous for an AT III molecular abnormality affecting the binding site for heparin.
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Affiliation(s)
- A M Fischer
- The Département d’Hématologie, C. H. U. Necker-Enfants Malades, Paris, France
| | - P Cornu
- The Département d’Hématologie, C. H. U. Necker-Enfants Malades, Paris, France
| | - C Sternberg
- The Département d’Hématologie, C. H. U. Necker-Enfants Malades, Paris, France
| | - F Mériane
- The Laboratoire d’Hématologie, C. H. U. Mustapha, Alger, Algérie
| | - M D Dautzenberg
- The Département d’Hématologie, C. H. U. Necker-Enfants Malades, Paris, France
| | - O Chafa
- The Laboratoire d’Hématologie, C. H. U. Mustapha, Alger, Algérie
| | - S Beguin
- The Département d’Hématologie, C. H. U. Necker-Enfants Malades, Paris, France
| | - M Desnos
- The Service de Cardiologie, Hôpital Boucicaut, Paris, France
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Amaouz C, Chafa O, Bouterfaia I, Ouzzani A, Semmar Z. Sécurité transfusionnelle : expérience du centre d’hémobiologie transfusion sanguine Med Benbadji du CHU Mustapha d’Alger. Transfus Clin Biol 2015. [DOI: 10.1016/j.tracli.2015.06.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Chafa O, Fischer AM, Reghis A, Tapon-Bretaudiere J. Homozygous nonsense mutation (Cys72-->stop) in the human F7 gene: a not life-threatening mutation despite the absence of circulating factor VII. J Thromb Haemost 2005; 3:175-7. [PMID: 15634284 DOI: 10.1111/j.1538-7836.2004.01089.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Helley D, Chafa O, Yaker NL, Reghis A, Fischer AM. Prevalence of the prothrombin gene 20210A mutation in thrombophilic and healthy Algerian subjects. Thromb Haemost 1999; 82:1554-5. [PMID: 10595654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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Chafa O, Reghis A, Aubert A, Fischer AM. Prevalence of the FVQ506 (factor V Leiden) mutation in the normal and thrombophilic Algerian population. Br J Haematol 1997; 97:688-9. [PMID: 9207426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Chafa O, Chellali T, Sternberg C, Reghis A, Hamladji RM, Fischer AM. Severe hypofibrinogenemia associated with bilateral ischemic necrosis of toes and fingers. Blood Coagul Fibrinolysis 1995; 6:549-52. [PMID: 7578897 DOI: 10.1097/00001721-199509000-00008] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Severe hypofibrinogenemia was found in an Algerian woman who, since the age of 37 years, suffered three different episodes of ischemic necrosis of the toes and fingers leading to amputation of the toes and surgical removal of necrotic tissue (necretomy). No anti-fibrinogen antibody was present. The deficiency appeared to be due to severe congenital hypofibrinogenemia since the fibrinogen level remained at the same low level over a long period, without any abnormality of other coagulation proteins. The thrombotic events may be explained by the increased thrombin generation observed in the patient's plasma, due to the lack of thrombin adsorption onto a fibrin net.
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Affiliation(s)
- O Chafa
- Service Hémobiologie-Transfusion, C.H.U. Mustapha, Alger, Algeria
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Chafa O, Fischer AM, Sternberg C, Meriane F, Millien C, Benabadji M. The relative frequency of inherited inhibitor deficiency among 93 young patients with thrombophilia in Algeria. Blood Coagul Fibrinolysis 1993; 4:639-40. [PMID: 8218863 DOI: 10.1097/00001721-199308000-00017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Chafa O, Fischer AM, Meriane F, Chellali T, Sternberg C, Otmani F, Benabadji M. Behçet syndrome associated with protein S deficiency. Thromb Haemost 1992; 67:1-3. [PMID: 1535461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Behçet syndrome is a multisystem disorder characterized by ocular, mucocutaneous, articular, gastrointestinal and neurologic abnormalities. We report here an unusual case of Behçet syndrome, characterized by the importance of the thrombotic events (7 phlebitis of both legs and resection of two toes). Additional manifestations of the Behçet syndrome occurred only 10 years after the first thrombotic episode. The oldest daughter of the propositus and his brother suffered also from thrombophlebitis; this familial history of thrombosis led to the performance of a haemostatic study. A congenital protein S deficiency was found in the propositus and in three of his children. Normal protein S levels were found in nine unrelated patients with Behçet syndrome. Thus this observation suggests that, when thrombotic manifestations are the first and major symptom of Behçet syndrome, an additional cause of thrombosis has to be investigated.
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Affiliation(s)
- O Chafa
- CTS, Service de Médecine, C.H.U. Mustapha, Alger, Algérie
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Abstract
Protein S inherited deficiency is associated with high risk of recurrent venous thrombotic disease (Broekmans et al, 1985a, b). Protein S exists as two forms in plasma, either free and functionally active or complexed with C4b-binding protein (C4b BP) and inactive (Dahlbäck & Stenflo, 1981). We report here the case of a 26-year-old woman and her brother, 28 years old, both suffering from recurrent venous thrombosis since the age of 20, diagnosed as severe protein S deficiency according to the following data: free protein S: 2.5-3% by ELISA, undetectable by electroimmunodiffusion (EID); total protein S: 13-16% by ELISA, 21-18% by EID, C4b BP: normal levels. Crossed immunoelectrophoresis using anti-protein S antibodies revealed only traces of protein S associated with C4b BP and no free protein S. All these assays were performed in the absence of any anticoagulant therapy. Among the investigated relatives, less severe protein S deficiency was observed in three children of the propositus: total protein S levels ranging from 41% to 50% (EID), 40-53% (ELISA); free protein S levels ranging from 16% to 18% (EID), 10-12% (ELISA); normal C4b BP levels. Crossed immunoelectrophoresis revealed traces of free protein S but a significant amount of protein S associated with C4b BP. From these results, we consider, according to Comp's classification (Comp et al, 1986a), that the propositus and her brother are the second case of protein S deficiency type II to be reported in the literature while her children belong to the type I category.
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Affiliation(s)
- O Chafa
- C.T.S., C.H.U. Mustapha, Alger, Algérie
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Fischer AM, Cornu P, Sternberg C, Mériane F, Dautzenberg MD, Chafa O, Beguin S, Desnos M. Antithrombin III Alger: a new homozygous AT III variant. Thromb Haemost 1986; 55:218-21. [PMID: 3715788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A qualitative abnormality of antithrombin III (AT III) was found in the plasma of a 41-year old patient. The plasmatic AT III antigen concentration was 130% and the progressive anti-F IIa and anti-F Xa activities were normal (105% and 137%). The plasma heparin cofactor activity was less than 10%, when measured by F IIa or F Xa inhibition. Crossed immunoelectrophoresis of AT III in the presence of heparin revealed in the plasma an abnormal slow-moving peak. When tested by affinity chromatography on heparin Sepharose, this abnormal AT III did not bind to heparin. Among the investigated relatives, 5 subjects had normal AT III levels, whatever the test used, the nine others having reduced levels of antithrombin heparin cofactor activity (45-61%) but normal levels of immunoreactive AT III (97-122%). Consanguinity was found in the family history. We therefore considered our patient as homozygous for an AT III molecular abnormality affecting the binding site for heparin.
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