title: Heterozygous protein C deficiency and coumarin necrosis of the skin.
abstract: An obese female patient aged 47 with a personal and familial history of recurrent venous thrombosis, who developed a coumarin-induced skin necrosis is presented. Laboratory investigations, performed three months after the acute event and in absence of coumarin therapy, emphasized a decreased anticoagulant activity of her plasma protein C (50% of the normal). These results as well as the high incidence of thrombotic disease in her relatives point to a familial heterozygous protein C deficiency. The antithrombotic role of the protein C system and the mechanism of coumarin induced necrosis of the skin are briefly discussed.
authors.affiliation: First Medical Clinic, Cluj-Napoca, Romania.
authors.forename: M
authors.initials: M
authors.lastname: Cucuianu
authors.forename: N
authors.initials: N
authors.lastname: Hagău
authors.forename: M
authors.initials: M
authors.lastname: Cotul
authors.forename: E
authors.initials: E
authors.lastname: Cardan
authors.forename: I
authors.initials: I
authors.lastname: Giurgea
mesh_terms: D003374:Coumarins / Q000009:adverse effects*; D005260:Female; D006579:Heterozygote; D006801:Humans; D008875:Middle Aged; D009336:Necrosis; D011486:Protein C / Q000032:analysis; D020151:Protein C Deficiency; D012867:Skin / Q000187:drug effects* / Q000473:pathology; D013924:Thrombophlebitis / Q000097:blood / Q000175:diagnosis* / Q000473:pathology
chemical_list: D003374:Coumarins; D011486:Protein C; C030123:coumarin