Protein S deficiency in a case of superor sagital vein thrombosis.

Cortical vein thrombosis (CVT) is rare and is most common in the third decade of life. Cerebral venous thrombosis may be due to a variety of pathologic conditions like deficiencies of protein S (PS), antithrombin III, protein C, factor V Leiden, prothrombin gene mutations and hyperhomocysteinemia. Protein S is a vitamin K-dependent anticoagulant present in plasma and prevent thrombosis in association with protein C. Lack of it results in venous thromboembolism (VTE) rarely causing thrombosis of cerebral venous sinuses. Our patient is a 35-year-old male who presented with focal seizures. MRI brain showed venous infarcts, and MR venogram showed extensive thrombosis of superior sagittal sinus. Later work up for hypercoagulable state showed significant Protein S deficiency.

Bone marrow study in patients with Human Immune Deficiency Virus and Acquired Immune Deficiency Syndrome

Introduction: Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) can involve almost any organ system. The study was aimed to assess the various bone marrow abnormalities seen in HIV/AIDS patients with haematologic abnormalities. Materials and Methods: 43 HIV infected patients were included in the study. Baseline haematological investigations included full blood count, CD4 positive lymphocyte counts, and absolute lymphocyte count. Bone marrow aspiration and trephine biopsy were done in all patients. Bone marrows of these patients were carefully evaluated for any abnormalities. HIV positive patients were classified into AIDS group (76%) and non-AIDS (24%) group using National AIDS Control Organisation (NACO) criteria. Results: Normocytic normochromic anaemia was the most common peripheral haematological finding occurring in 72% of patients. The AIDS group had statistically significant lower platelet counts (p=0.004) but no differences in the other parameters. Bone marrow was normocellular in 63.6% in the AIDS group and 100% in the non-AIDS group. Dysplasia was observed in 37.2% of patients, predominantly affecting granulocytic series. Myelodysplasia was statistically associated with a low platelet count. Reduced marrow lymphoid precursors (CD4+) were seen in 37.2% of patients. Conclusions: Bone marrow abnormalities were common in HIV/AIDS patients with haematological abnormalities. The AIDS group had a statistically significant lower platelet count. Myelodysplasia was found in 37.2% of patients with HIV disease and was also statistically associated with a lower CD4+ lymphocyte count.