A 53-YEAR-OLD asymptomatic white man was evaluated for a possible thrombotic tendency after the death of his 19-year-old son from a pulmonary embolus. The father and his relatives had no history of venous thrombotic disease, but there was a history of coronary artery disease in the family. Physical examination of the father was normal.The deceased son had been athletic and was healthy until he sustained a knee injury that required surgery. His postoperative course had been uneventful for 8 weeks after the surgery, when he died suddenly. The postmortem examination revealed a massive pulmonary embolism. Testing performed on a postmortem blood sample was said to show low protein C levels.Laboratory tests showed that the father had a normal complete blood cell count and platelet count and normal results on screening coagulation tests (prothrombin time, activated partial thromboplastin time, thrombin time, and fibrinogen). Immunologic assays for antithrombin
Rick ME. Protein C and Protein SVitamin K—Dependent Inhibitors of Blood Coagulation. JAMA. 1990;263(5):701–703. doi:10.1001/jama.1990.03440050095041
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