Ishikawa Akihisa, Ito Hitoshi, Hotta Soichi, Ono Satoshi, Kakinoki Nobushige, Kishimoto Yosuke, Kamoshida Toshirou, Hirai Shinji, Oka Yuji
Department of Gastroenterology, Hitachi General Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2007 Jun;104(6):822-8.
A 25-year-old man was admitted to our hospital because of abdominal pain, nausea and low-grade fever. An abdominal CT showed remarkable thickening of the wall of the small intestine and extensive thrombosis of the mesenteric, portal and splenic veins. Because neither intestinal infarction nor peritonitis was seen, anticoagulation therapy was chosen. Heparin was administered intravenously and was used alternatively with warfarin later. The patient's symptoms and clinical data improved gradually. Concerning the etiological factors of the thrombosis, only protein S activity definitely decreased. Genetic analysis indicated a variant of protein S, protein S Tokushima.
一名25岁男性因腹痛、恶心和低热入院。腹部CT显示小肠壁明显增厚,肠系膜、门静脉和脾静脉广泛血栓形成。由于未发现肠梗死或腹膜炎,选择了抗凝治疗。静脉注射肝素,随后交替使用华法林。患者的症状和临床数据逐渐改善。关于血栓形成的病因,只有蛋白S活性明显降低。基因分析显示存在蛋白S的一种变异体,即德岛蛋白S。