Testicular infarction secondary to protein S deficiency: a case report
1 The Department of Surgery, Daisy Hill Hospital, Newry, Co Down, BT35 8DR, N. Ireland, UK
2 C/O The Department of Surgery, The Institute of Clinical Science, The Royal Victoria Hospital, Belfast, BT12 6BA, N. Ireland, UK
BMC Urology 2006, 6:17 doi:10.1186/1471-2490-6-17Published: 7 July 2006
Protein S deficiency is an inherited cause of thrombophilia. We present the second reported case in the literature of a man developing testicular infarction secondary to protein S deficiency.
A 63 year old man presented with sudden onset of pain in his left hemi-scrotum. Despite oral warfarin therapy the plasma INR was only 1.4 at presentation. Doppler ultrasound scan of the scrotum confirmed absent blood flow to the left testis with increased echogenicity. Orchidectomy was performed to remove the necrotic testis. Post-operatively the patient did well and was referred to the Regional Haemophilia and Thrombosis Centre for further management.
The case highlights a rare but potential complication of protein S deficiency and demonstrates the importance of adequate anticoagulation in these patients.