Protein C deficiency: Report of a challenging case with recurrent multiorgan thrombosis

Introduction and importance: Protein C deficiency is a rare disorder associated with an increased risk of developing abnormal blood clots. Mild and heterozygous cases are usually asymptomatic and may present with recurrent thrombosis. These recurrent thrombi are usually associated with ischemic stroke or concomitant thrombosis during pregnancy and recurrent miscarriage, but arterial thrombosis is relatively uncommon. Case presentation: In this case report, we introduce an interesting 21-year-old female patient with a protein C deficiency, which presented with a set of symptoms related to ischemia and thrombosis in several different systems, including the colon, brain, and lower extremities. Clinical discussion: With the diagnosis of ischemic colitis, she underwent medical treatment with hydration, antibiotics, anticoagulant, and GI rest. She was discharged with a suitable response to medical treatment and good general condition. One month later, the patient presented with right upper limb paresis and speech disorder, and at the same time, he had swelling of the left lower limb. The patient was diagnosed with DVT of the common femoral vein and protein c deficiency and treated appropriately with anticoagulant (heparin 1000 lU/h) and was discharged with oral rivaroxaban after symptoms improved. Conclusion: In young patients with ischemic colitis without a history of previous surgery, increased coagulation should be considered, including impaired fibrinolysis and impaired microcirculation and inflammatory processes. Protein C deficiency is one of several reasons for thrombotic disorders that should be considered in these people, especially if they have a history of DVT or other vascular thromboses. © 2021 The Author(s)