What question did this study set out to answer?

The research aims to investigate the unusual presentation of a procoagulant state in patients with specific symptoms and laboratory findings.

June 8, 2026Vidarbha Journal of Internal Medicine0 citationsOpen Access

Unusual Presentation of Procoagulant State

SAShalini AgrawalDeen Dayal Upadhyaya Gorakhpur University

Key Points

The research aims to investigate the unusual presentation of a procoagulant state in patients with specific symptoms and laboratory findings.
Evaluated a patient presenting with unexplained skin changes and recurrent symptoms over three years.
Conducted routine blood tests, including functional protein S activity analysis and imaging studies (ultrasonography).
Assessed patient's medical history and family history for potential thromboembolic events.
Functional protein S activity was decreased at 10%, indicating a potential procoagulant state.
Routine blood investigations showed anemia (Hb 9.7 gm/dL) and elevated ESR (65 mm/1st hour).
Imaging studies showed no significant abnormalities, except for an ectopic right kidney.

Abstract

clubbing was noted.General examination was unremarkable except for a 5 cm long, nontender, hyperpigmented, cord-like induration on the flexor aspect of her left forearm.Systemic examination was unremarkable.On enquiry, patient revealed a history of recurrent similar patches on both legs and arms, with spontaneous resolution within weeks over the last 3 years.There was no history suggestive of major thromboembolism in the past.No significant family history was revealed.Routine blood investigations revealed Hb 9.7 gm/dL, normal total leukocyte count (TLC) and differential leukocyte count (DLC), PC 3.51 lakhs/mm³, ESR 65 mm/1st hour.Liver function test (LFT) and kidney function test (KFT) were within normal limits (WNL), and urine examination was unremarkable.Patient's follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels were within normal range.Bleeding time and clotting time were WNL (3.1 and 6.05 minutes, respectively).S. ANA was negative.Antithrombin III and functional protein C levels were normal.Functional protein S activity was found to be decreased at 10% (determined by electromechanical clot detection method).Ultrasonography (USG) abdomen showed ectopic right kidney and was otherwise WNL.Chest X-ray (CXR) posteroanterior (PA) view was normal, with no suggestion of tuberculosis.Mantoux test was negative.

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