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Unexpected normal ROTEM results in protein C deficiency with IVC thrombosis
  1. Rachel Seunah Kim and
  2. Uzung Yoon
  1. Anesthesiology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USA
  1. Correspondence to Rachel Seunah Kim; rachelseunah{at}gmail.com

Abstract

Protein C deficiency is a hereditary disorder that increases the risk of thrombotic events but has unclear effects on rotational thromboelastometry (ROTEM) analysis. A man in his 60s with a history of protein C deficiency and multiple thrombotic events underwent inferior vena cava (IVC) filter removal, iliocaval thrombectomy and infrarenal IVC placement for IVC-related complete iliocaval and common femoral vein thromboses. A ROTEM analysis showed normal coagulation in NATEM and EXTEM and only a slight shortening in A10 and A20 in INTEM, which was unexpected given his diagnosis of protein C deficiency. Normal results indicate that there is complexity and variability of coagulation to maintain a balanced state even in individuals with underlying coagulation disorders.

  • Pain
  • Thrombosis

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Footnotes

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: RSK and UY. The following author gave final approval of the manuscript: UY. UY is the guarantor.

  • Funding no funding

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.