Abstract
Warfarin-induced skin necrosis is the rare but potentially devastating complication of anticoagulant therapy and commonly occurs in previously undetected C- and S-protein deficient patients. Because routine preoperative examination does not include protein C and S level measurement, detection of these patients preoperatively is generally not possible, which increases the risk of occurrence of this important complication. In this report we present and discuss such a patient, who died from warfarin-induced skin necrosis after coronary artery bypass surgery.
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WG McGehee TA Klotz DJ Epstein SI Rapapor (1984) ArticleTitleCoumarin necrosis associated with hereditary protein C deficiency Ann Intern Med 101 59–60 Occurrence Handle6547283 Occurrence Handle1:STN:280:DyaL2c3ivFKmsw%3D%3D
V Grimaudo F Gueissaz T Hauert A Sarraj E Kruithof F Bachmann (1989) ArticleTitleNecrosis of the skin induced by coumarin in a patient deficient in protein S BMJ 298 233–234 Occurrence Handle2522326 Occurrence Handle1:STN:280:DyaL1M7mslWktw%3D%3D Occurrence Handle10.1136/bmj.298.6668.233
SV D'Angelo PC Comp CT Esmon A D'Angelo (1986) ArticleTitleRelationship between protein C antigen and anticoagulant activity during oral anticoagulation and in selected disease states J Clin Invest 77 416–425 Occurrence Handle3511097 Occurrence Handle10.1172/JCI112319
O Koner S Tekin N Soybir F Gulcan K Karaoglu (2000) ArticleTitleCardiac operation in a patient with combined homozygous protein C and protein S deficiency J Cardiothorac Vasc Anesth 14 IssueID2 188–190 Occurrence Handle10794341 Occurrence Handle10.1016/S1053-0770(00)90017-X Occurrence Handle1:STN:280:DC%2BD3c3lt1eitw%3D%3D
MD Smirnov O Safa NL Esmon CT Esmon (1999) ArticleTitleInhibition of activated protein C anticoagulant activity by prothrombin Blood 94 IssueID11 3839–3846 Occurrence Handle10572099 Occurrence Handle1:CAS:528:DyaK1MXnslyktbs%3D
K Parsi I Younger J Gallo (2003) ArticleTitleWarfarin-induced skin necrosis associated with acquired protein C deficiency Australas J Dermatol 44 57–61 Occurrence Handle12581084 Occurrence Handle10.1046/j.1440-0960.2003.00639.x
DD Ad-El A Meirovitz A Weinberg L Kogan D Arieli A Neuman D Linton (2000) ArticleTitleWarfarin skin necrosis: local and systemic factors Br J Plast Surg 53 624–626 Occurrence Handle11000083 Occurrence Handle10.1054/bjps.2000.3402 Occurrence Handle1:STN:280:DC%2BD3M7hsF2hsA%3D%3D
D Gailani EP Reese (1999) ArticleTitleAnticoagulant-induced skin necrosis in a patient with hereditary deficiency of protein S Am J Hematol 60 231–236 Occurrence Handle10072117 Occurrence Handle10.1002/(SICI)1096-8652(199903)60:3<231::AID-AJH12>3.0.CO;2-N Occurrence Handle1:STN:280:DyaK1M7ntVegsQ%3D%3D
M Egred E Rodrigues (2005) ArticleTitlePurple digit syndrome and warfarin-induced skin necrosis Eur J Intern Med 16 294–295 Occurrence Handle16084358 Occurrence Handle10.1016/j.ejim.2004.11.014 Occurrence Handle1:STN:280:DC%2BD2MvhvFKktQ%3D%3D
T Ng ML Tillyer (2001) ArticleTitleWarfarin-induced skin necrosis associated with Factor V Leiden and protein S deficiency Clin Lab Haematol 23 261–264 Occurrence Handle11683790 Occurrence Handle10.1046/j.1365-2257.2001.00399.x Occurrence Handle1:STN:280:DC%2BD3MnhtVSktA%3D%3D
JA Stewart ID Penman MK Cook CA Ludlam (1999) ArticleTitleWarfarin-induced skin necrosis Postgrad Med J 75 IssueID882 233–235 Occurrence Handle10715767 Occurrence Handle1:STN:280:DC%2BD3c7otVKmtQ%3D%3D
S Moll (2004) ArticleTitleWarfarin-induced skin necrosis Br J Haematol 126 628 Occurrence Handle15327512 Occurrence Handle10.1111/j.1365-2141.2004.05095.x
DW Essex SS Wynn DK Jin (1998) ArticleTitleLate-onset warfarin-induced skin necrosis: case report and review of the literature Am J Hematol 57 233–237 Occurrence Handle9495376 Occurrence Handle10.1002/(SICI)1096-8652(199803)57:3<233::AID-AJH10>3.0.CO;2-B Occurrence Handle1:STN:280:DyaK1c7lsVOltg%3D%3D
Y Yang KM Alkazy (1999) ArticleTitleWarfarin induced skin necrosis in a patient with a mutation of the prothrombin gene N Engl J Med 340 IssueID9 735 Occurrence Handle10068331 Occurrence Handle10.1056/NEJM199903043400912 Occurrence Handle1:STN:280:DyaK1M7ltVSkug%3D%3D
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Oz, B., Asgun, F., Oz, K. et al. Warfarin-induced skin necrosis after open heart surgery due to protein S and C deficiency. Heart Vessels 22, 64–66 (2007). https://doi.org/10.1007/s00380-006-0935-z
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DOI: https://doi.org/10.1007/s00380-006-0935-z