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Today, 11 October 2008

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Yesterday, 10 October 2008

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Maureen: I'm phoning about my daughter who has a blood condition that I'm sure you're aware of called protein S deficiency. She actually inherited it from me.

Harry: So she has developed clots in her veins, is that right?

Maureen: Well she is actually now on warfarin.

Harry: The condition that you are speaking about is not too uncommon. What is does is causes clots in the leg veins - what we call deep-veined thrombosis, but it can happen in other veins as well. Why this is serious is that a piece of that clot may break off and go to the lung. Now in her particular case I would imagine she just had the clots in her veins, is that right?

Maureen: No, two years ago she went to her GP because she kept on getting spots on her face. The GP put her onto a pill called Dianne 35. That caused her to get a pulmonary embolism and she was obviously very critically ill.

Harry: I'm glad you've raised this point because often the way in which this condition comes to light, especially in ladies, is when they're on the pill which has the risk in any case of causing thrombosis. Now if in addition to the pill you've got this underlying genetic predisposition, it is much more likely to occur. And so what you're describing is absolutely typical. And unfortunately the treatment is to give her a blood thinner, which is warfarin, and she may have to take this for a very long time.

Maureen: I think she may be on it for life. She got married and she had a baby, but for the last five months she's been put back full time onto warfarin. What I'd like to know is if you're on warfarin, does it obviate all chance of having another thrombosis.

Harry: No, there is no medicine which is totally effective, but it will reduce the chances to a very large extent. In other words the efficacy is very high provided it is taken regularly and her blood is checked to make sure that she is taking enough to exert the requisite anti-clotting effect.

Maureen: Well she goes to a very good haematologist at the General Hospital.

Harry: With those provisos, the chances that she will have another episode are very small.

Maureen: Well she has been having pain in her chest just recently.

Harry: Obviously any symptom whatsoever suggesting thrombosis, whether it's a pain in the leg, swelling in the leg or any chest symptoms - it is of the greatest importance that she see the doctor straight away.

Maureen: Yes well she did and everything was clear, but I was just concerned about the predisposition. Thank you very much.