PMID- 15253263
OWN - NLM
STAT- MEDLINE
DCOM- 20041108
LR  - 20171118
IS  - 0890-5096 (Print)
IS  - 0890-5096 (Linking)
VI  - 18
IP  - 2
DP  - 2004 Mar
TI  - A case of warfarin skin necrosis despite enoxaparin anticoagulation in a patient 
      with protein S deficiency.
PG  - 237-42
AB  - Warfarin-induced skin necrosis is a rare complication associated with the use of 
      oral anticoagulants. Most patients develop this at the initiation of therapy, 
      often while still receiving intravenous unfractionated heparin (UFH). Recently, 
      low-molecular-weight heparins (LMWHs) have gained wider use, providing an option 
      for outpatient treatment of deep-vein thrombosis. The treatment protocols are 
      similar to UFH, including the early initiation of oral anticoagulation with 
      warfarin. A Medline search failed to reveal any cases of warfarin-induced skin 
      necrosis while using a LMWH. We present a patient with protein S deficiency who 
      developed warfarin skin necrosis despite appropriate anticoagulation with 
      enoxaparin, and review the chemical and clinical difference between UFH and LMWH.
FAU - Tai, Chau Y
AU  - Tai CY
AD  - Department of Surgery, Cooper Health System University Medical Center, University 
      of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, 
      Camden 08103, USA.
FAU - Ierardi, Ralph
AU  - Ierardi R
FAU - Alexander, James B
AU  - Alexander JB
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - Netherlands
TA  - Ann Vasc Surg
JT  - Annals of vascular surgery
JID - 8703941
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 5Q7ZVV76EI (Warfarin)
SB  - IM
MH  - Anticoagulants/*adverse effects
MH  - Arterial Occlusive Diseases/surgery
MH  - Enoxaparin/*therapeutic use
MH  - Female
MH  - Fibrinolytic Agents/therapeutic use
MH  - Heparin, Low-Molecular-Weight/therapeutic use
MH  - Humans
MH  - Middle Aged
MH  - Necrosis
MH  - Popliteal Artery/surgery
MH  - Postoperative Complications/drug therapy/etiology
MH  - Protein S Deficiency/*drug therapy
MH  - Skin Diseases/*chemically induced
MH  - Subclavian Vein/pathology
MH  - Tibial Arteries/surgery
MH  - Treatment Failure
MH  - Vascular Surgical Procedures
MH  - Venous Thrombosis/drug therapy/etiology
MH  - Warfarin/*adverse effects
EDAT- 2004/07/16 05:00
MHDA- 2004/11/09 09:00
CRDT- 2004/07/16 05:00
PHST- 2004/07/16 05:00 [pubmed]
PHST- 2004/11/09 09:00 [medline]
PHST- 2004/07/16 05:00 [entrez]
AID - S0890-5096(06)61127-8 [pii]
AID - 10.1007/s10016-003-0080-4 [doi]
PST - ppublish
SO  - Ann Vasc Surg. 2004 Mar;18(2):237-42. doi: 10.1007/s10016-003-0080-4.