PMID: 3755068Jun 1, 1986Paper

Coumarin induced acral skin necrosis associated with hereditary protein C deficiency

Blut
I PabingerH Niessner

Abstract

Hemorrhagic skin necrosis of the toes was observed in a patient with heterozygous protein C deficiency (protein C:Ag 32% and protein C activity 30%) on the 4th day of coumarin treatment overlapping with effective intravenous anticoagulation with heparin. Family studies revealed protein C deficiency in two sisters of the proposita without a history of thromboembolic disease. Immunologic studies in the proposita at the time of coumarin necrosis revealed slight depression of complement factor C4 and the presence of immune complexes. The present case and review of the literature show that the pathogenetic mechanism leading to coumarin necrosis in patients with protein C deficiency seems not yet to be fully understood.

References

Oct 1, 1985·Seminars in Thrombosis and Hemostasis·I Pabinger-Fasching, E Deutsch
Nov 1, 1969·Archives of Dermatology·E D Everett, E L Overholt
Mar 1, 1984·The New England Journal of Medicine·U SeligsohnS I Rapaport
Jul 1, 1984·Annals of Internal Medicine·W G McGeheeS I Rapaport
Dec 15, 1983·Thrombosis Research·R B Francis, M J Patch
Aug 1, 1983·The Journal of Urology·A C WeinbergD G Skinner
May 17, 1965·JAMA : the Journal of the American Medical Association·R M NALBANDIANE C RUPP

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Citations

Jul 1, 1991·American Journal of Hematology·J E HumphriesJ E Connelly
Nov 1, 1988·Journal of the American Academy of Dermatology·S J Miller
Jun 1, 1990·Journal of the American Academy of Dermatology·C P Samlaska, W D James
May 29, 2016·The American Journal of Medicine·Ewa M WysokinskaRobert D McBane
Jun 1, 1996·American Journal of Hematology·A P Jillella, C L Lutcher
Jun 1, 1989·Journal of Neurology, Neurosurgery, and Psychiatry·W R Gibb

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