Does your blood clot easily? Let's talk about Protein S Deficiency!

Have you ever thought about how important blood clotting is in our bodies? It is because of this process that bleeding stops when there is a small injury. But, what if blood clots inside the body for no reason? That can be a bit dangerous. Today we are going to talk about such a condition. That is Protein S deficiency, or `(Protein S Deficiency)`.

Simply put, what is Protein S deficiency?

Think of the blood clotting process in our body as a traffic police officer controlling a traffic jam. There needs to be someone to keep everything in check. Similarly, one of the most important proteins that controls the blood clotting in our body is Protein S.

Now, Protein S deficiency means that we have less of the so-called "police officer" or Protein S in our body than we need. What happens then? Since there is no one to control the blood clotting process, it becomes overactive and blood clots start to form unnecessarily.

Blood clots that form in this way often form in the deep veins of the legs. We call this a deep vein thrombosis (DVT) . Sometimes this blood clot can break away from there and travel with the blood to the lungs and get stuck. This is an even more dangerous condition. We call it a pulmonary embolism (PE) . Rarely, these blood clots can also form in the veins of the brain or abdomen.

How common is this condition? And when is the risk highest?

Protein S deficiency is actually a relatively rare condition. Most of the time, it's hereditary, meaning it's genetic. But it can also be caused by some external factors.

If you have this condition, there are certain situations where you may be at an increased risk of developing blood clots. Let's take a look at what those situations are.

What are the symptoms of this condition?

Most of the time, a person with Protein S deficiency will not have any symptoms until a blood clot forms. If a blood clot forms, the symptoms will vary depending on where it forms.

• If you develop a blood clot (DVT) in your leg:
• Swelling of one leg, especially the groin area.
• Feeling pain or stiffness in the leg.
• Redness or a feeling of warmth in the skin of the leg.
• If you develop a blood clot (PE) in the lungs (this is an emergency):
• Sudden difficulty breathing.
• Chest pain, especially when taking a deep breath.
• Rapid breathing and increased heart rate for no reason.
• Dizziness or loss of consciousness.
• Bloody mucus discharge.
• During pregnancy: Miscarriages or other complications may occur.
• In young children (in the most severe cases): Stroke-like conditions may occur.

Why does this Protein S deficiency occur?

There are two main reasons for this. One is inherited (inherited) and the other is acquired (acquired) .

1. Hereditary causes

This is the most common one. The production of Protein S in our body is controlled by a gene called PROS1 . If there is a mutation or change in this gene, the production of Protein S is impaired.

• If you inherit this mutated gene from only one parent , you will have mild Protein S deficiency.
• If you inherit this gene from both parents , you will have a very severe form of the deficiency. This is very rare.

2. External causes

Some medical conditions or circumstances can also cause low levels of Protein S in the body. This is more common than hereditary.

How do you find this, Doctor?

Your doctor may be suspicious of this, especially in cases like these:

• If someone in your family has a history of frequent blood clots (Venous Thromboembolism).
• If you have repeated blood clots .
• If you have had a blood clot before the age of 50, without a specific cause being found .
• If a blood clot has formed in unusual places where blood clots do not normally form (such as the brain, intestines, liver) .

If this type of suspicion arises, the doctor will do the following to confirm the diagnosis:

1. Blood tests: Your blood will be checked for Protein S levels and other factors related to blood clotting.

2. Physical examination: A complete body examination will be performed to check for other problems.

3. Your medical history: We will ask you about your medical conditions and those of your family.

How is it treated?

The treatment method depends on whether or not you have a blood clot.

However, if you already have a blood clot (DVT or PE), your doctor will start you on anticoagulants . These work by stopping new blood clots from forming and by preventing existing clots from getting bigger. The most common types of medication used are:

• Heparin
• Warfarin
• Rivaroxaban
• Apixaban
• Dabigatran

Here's something you should know: If your doctor decides to give you a medicine called ``Warfarin,'' he or she will need to give you a medicine called ``Heparin'' (often as an injection) a few days before. If you don't, you can sometimes develop a complication called blood clots in the skin and soft tissues. But this problem doesn't occur with other newer medicines.

Your treatment may last from a few months to a lifetime, depending on when your blood clot formed and other risk factors.

What do you do for people who don't have a blood clot, but have a deficiency?

The doctor's goal for people like this is to help prevent blood clots from forming.

• You may be advised not to take medications that increase blood clotting, such as birth control pills.
• If you are undergoing surgery, are pregnant, or are confined to bed for a while due to an accident , you may be recommended to use blood thinners temporarily for that period only.

How should I take care of myself?

• If you are taking Warfarin: You will need to have your INR checked at regular intervals .You will need to have a blood test. This will check if the dose of `(Warfarin)` you are being given is correct. Because the dose of this medicine may need to be changed from time to time.
• If you are taking blood thinners: Be careful of bleeding. Be careful when using sharp objects like knives. It is better to use a soft toothbrush and an electric razor.
• Be aware of the symptoms of DVT and PE: You should be able to recognize symptoms such as leg swelling, chest pain, and shortness of breath if they occur.

When should I see the doctor and go to the ETU?

### Call your doctor immediately in these cases:

• If you fall or have another accident while taking blood thinners.
• If there is any unusual bleeding (e.g. nosebleeds, blood in urine or stool).
• If you suspect you have a DVT (blood clot in the leg) .

### If you have these symptoms, go to the Emergency Department (ETU) immediately:

• If you are taking blood thinners and you are vomiting blood or coughing up blood .
• If you hit your head or suddenly develop a severe headache .
• If there is bleeding that cannot be stopped .
• If you think you have symptoms of PE (blood clot in the lung) (sudden shortness of breath, chest pain, fast heartbeat, dizziness).