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Protein Z deficiency in antiphospholipid-negative Sneddon's syndrome.
[sneddon syndrome]
Sneddon
's
syndrome
is
characterized
by
the
association
of
ischemic
cerebrovascular
events
and
widespread
livedo
racemosa
.
The
pathophysiology
of
Sneddon
's
syndrome
remains
elusive
,
but
various
prothrombotic
abnormalities
have
been
previously
reported
in
this
setting
.
Low
levels
of
protein
Z
,
a
downregulator
of
coagulation
,
have
been
recently
linked
to
an
increased
risk
of
arterial
thrombosis
.
The
purpose
of
this
study
was
to
investigate
the
levels
of
protein
Z
in
a
series
of
Sneddon
's
syndrome
patients
without
circulating
antiphospholipid
antibodies
in
comparison
with
an
age-
and
sex-matched
control
population
.
Twenty
-
six
patients
and
78
healthy
controls
had
determination
of
their
protein
Z
blood
levels
by
an
enzyme-linked
immunoassay
test
.
Patients
'
thrombotic
and
vascular
risk
factors
,
including
tobacco
smoking
,
arterial
hypertension
,
oral
contraceptive
agents
,
dyslipidemia
,
factor
V
Leiden
,
and
factor
II
mutation
were
recorded
.
Protein
Z
plasma
levels
were
significantly
lower
in
patients
(
mean
1
.
47
mg
/
L
)
than
in
controls
(
mean
1
.
93
mg
/
L
)
(
P
=
0
.
02
)
.
Prevalence
of
protein
Z
deficiency
(
level
<
1
mg
/
L
)
was
significantly
higher
(
P
=
0
.
001
)
among
patients
(
31
%
)
than
among
controls
(
3
.
8
%
)
.
Factor
V
Leiden
and
heavy
smoking
were
observed
in
4
and
7
patients
,
respectively
.
Sneddon
's
syndrome
could
be
viewed
as
the
peculiar
clinical
expression
of
various
and
sometimes
associated
coagulation
abnormalities
.
Low
levels
of
protein
Z
may
account
,
at
least
partly
,
for
the
thrombotic
events
observed
in
Sneddon
's
syndrome
and
shed
a
new
light
on
its
pathophysiology
.
Clinical
implications
for
protein
Z
deficiency
in
this
setting
deserve
further
investigations
.
Diseases
Validation
Diseases presenting
"hypertension"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
aniridia
aromatase deficiency
cadasil
child syndrome
cohen syndrome
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cushing syndrome
cystinuria
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
fabry disease
familial hypocalciuric hypercalcemia
gm1 gangliosidosis
heparin-induced thrombocytopenia
hereditary cerebral hemorrhage with amyloidosis
holt-oram syndrome
homocystinuria without methylmalonic aciduria
hydrocephalus with stenosis of the aqueduct of sylvius
inclusion body myositis
kallmann syndrome
kindler syndrome
lamellar ichthyosis
lymphangioleiomyomatosis
pendred syndrome
primary effusion lymphoma
scrub typhus
severe combined immunodeficiency
sneddon syndrome
typhoid
von hippel-lindau disease
well-differentiated liposarcoma
werner syndrome
x-linked adrenoleukodystrophy
zellweger syndrome
This symptom has already been validated