Thrombophilia due to activated protein C resistance

Thrombophilia is a hereditary or acquired condition that predisposes individuals to thrombo-embolic events. In patients with a positive family history, or young patients without clear-cut risk factors for thrombosis, it is a relatively easy decision to recommend a thrombophilia profile. The problem arises when these risk factors are camouflaged under the presence of other known and relatively common factors like hypertipidaemia, cigarette smoking, etc. Here we describe the case of an elderly male who was a chronic smoker and a hypertensive, who presented to us with a neuro-deficit secondary to a pontineinfarct. He had suffered in the past from deep vein thrombosis and claudication due to arterial obstruction. Investigations revealed that he had an underlying Activated protein C resistance due to factor V Leiden mutation.