How would you approach protein S deficiency found on hypercoagulability work-up in a patient with a post-operative central retinal vein occlusion?   

I agree with Dr. @Louis M. Aledort's approach. A few caveats: 1) protein S deficiency is probably one of the most commonly misdiagnosed thrombophilia. Several variables affect the protein S activity assay, the antigen assays are more reliable but also affected by several variables (e.g. vitamin K de...

1. Inc incidence of postpartum intracranial dural sinus venous thromboses particularly in S Asians that I saw. 2. Diagnosis tricky be careful about methodology (testing platform), many nuances must understand the testing methodology. Can have multiple prothrombotic mutations, sometimes ameliorated ...

Echoing the sentiments, below, I think the primary question is how one determines a patient has "protein s deficiency". Protein S antigen fluctuates with a number of physiologic conditions, and the presence of a low S activity level is not necessarily indicative of an inherited thrombophilia. S...

Protein S deficiency is one of the most prothrombotic deficiencies. Retinal thrombosis may be the beginning of more serious thrombosis, therefore, lifelong anticoagulation. On Coumadin RX forever with INR 1.5 to 2. This is from my long experience.