Pseudotumour cerebri after varicella

Thrombotic complications in children with varicella are well known. Transient protein S deficiency due to the presence of an anti-protein S antibody seems to be responsible at least in part. In an 8-year-old girl, pseudotumour cerebri with abducens palsy and ileofemoral vein thrombosis occurred 3 weeks after chickenpox. A transient elevation of anti-protein S auto-antibodies was identified. Under treatment with heparin the pseudotumour cerebri rapidly disappeared but the iliofemoral thrombosis persisted. Thrombotic complications after varicella might be mediated at least in part by antibodies against protein S. Early recognition of this condition permits appropriate treatment with recombinant tissue-type plasminogen activator.