Although the patient had a severe bleeding event during anticoagulation therapy, he recovered well after active treatment and dynamic monitoring of anti-Xa.<h4>Conclusion</h4>Hereditary protein S deficiency caused by a mutation in the PROS1 gene is the genetic basis of this patient, and Enoxaparin Sodium and rivaroxaban have been shown to be highly effective. The gene discussed is TNXA; the disease is hyperinsulinemic hypoglycemia, familial, 4.