There is therefore an imbalance between anticoagulation and thrombosis with a tendency towards thrombosis as Protein C is inhibited rapidly together with factor VII then factor IX, X, protein S and II respectively deplete slowly.1,11,12 This can predispose the patient to thrombosis and is worse in patients who already have protein C deficiency. This evidence concerns the gene PROS1 and hyperinsulinemic hypoglycemia, familial, 4.