{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T06:52:36Z","timestamp":1791442356703,"version":"4.3.3"},"reference-count":12,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":279,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Pediatrics"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To report a rare case of pediatric dilated cardiomyopathy (DCM) with suspected hereditary protein C, protein S, and antithrombin III deficiency presenting as ischemic stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Children with DCM are at increased risk of thromboembolism. Inherited thrombophilias are an uncommon but important cause of pediatric stroke and may coexist with cardiac disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>An 8\u2010year\u2010old female presented with heart failure and was diagnosed with severe DCM (LVEF \u223c24%). Despite medical therapy and antiplatelet prophylaxis, she developed acute right\u2010sided hemiparesis. MRI confirmed a left hemispheric ischemic stroke. Thrombophilia workup revealed reduced protein C (41.5%), protein S (50.7%), and antithrombin III (65.1%) levels, suggestive of a suspected inherited thrombophilic disorder, while PT\/aPTT\/INR remained normal. She was managed conservatively with antiplatelets and rehabilitation, showing partial neurological recovery. Follow\u2010up demonstrated improved cardiac function (LVEF \u223c50%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The coexistence of DCM and suspected inherited thrombophilia can predispose to ischemic stroke in children. Normal routine coagulation tests do not exclude thrombophilia; targeted screening should be considered in high\u2010risk cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/crpe\/3631063","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T06:19:54Z","timestamp":1791440394000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pediatric Dilated Cardiomyopathy With Suspected Hereditary Protein C\/S and Antithrombin III Deficiency Presenting as Ischemic Stroke\u2014A Rare Case Report"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2667-4923","authenticated-orcid":false,"given":"Muhammad Waleed","family":"Imran","sequence":"first","affiliation":[{"name":"Shifa College of Medicine  Islamabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9157-4416","authenticated-orcid":false,"given":"Muhammad","family":"Moaz","sequence":"additional","affiliation":[{"name":"Shifa College of Medicine  Islamabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3205-9393","authenticated-orcid":false,"given":"Sanwal Sardar","family":"Nawaz","sequence":"additional","affiliation":[{"name":"Shifa College of Medicine  Islamabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7368-8111","authenticated-orcid":false,"given":"Amna","family":"Ilyas","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Shifa International Hospital  Islamabad Pakistan  shifa.com.pk"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabeen","family":"Abid","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Shifa International Hospital  Islamabad Pakistan  shifa.com.pk"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"e_1_2_8_1_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2013.105"},{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2011.10.033"},{"key":"e_1_2_8_3_2","first-page":"255","volume-title":"Park\u2019s Pediatric Cardiology for Practitioners","author":"Park M. K.","year":"2020"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-015-3165-8"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0735-1097(85)80319-3"},{"key":"e_1_2_8_6_2","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global Burden of 369 Diseases and Injuries in 204 Countries and Territories, 1990\u20132019: A Systematic Analysis for the Global Burden of Disease Study 2019","volume":"396","author":"GBD 2019 Diseases and Injuries Collaborators","year":"2020","journal-title":"Lancet"},{"key":"e_1_2_8_7_2","first-page":"459","article-title":"Protein C and Protein S Deficiency-Practical Diagnostic Issues","volume":"22","author":"Wypasek E.","year":"2013","journal-title":"Advances in Clinical and Experimental Medicine"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.1053\/spen.2000.20074"},{"key":"e_1_2_8_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/08830738221129916"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.4065\/76.3.319"},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0167-5273(93)90008-5"},{"key":"e_1_2_8_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/MBC.0b013e3282eff788"}],"container-title":["Case Reports in Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crpe\/3631063","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crpe\/3631063","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crpe\/3631063","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T06:19:55Z","timestamp":1791440395000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crpe\/3631063"}},"subtitle":[],"editor":[{"given":"Baisakhi","family":"Banerjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/crpe\/3631063"],"URL":"https:\/\/doi.org\/10.1155\/crpe\/3631063","archive":["Portico"],"relation":{},"ISSN":["2090-6803","2090-6811"],"issn-type":[{"value":"2090-6803","type":"print"},{"value":"2090-6811","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-04-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"3631063"}}