title: Familial type II protein C deficiency associated with warfarin-induced skin necrosis and bilateral adrenal hemorrhage.
abstract: A family is described in which venous thromboembolic disease is associated with reduced plasma protein C activity and normal levels of protein C antigen. Immunoelectrophoretic analysis of protein C antigen gave an abnormal pattern in all affected members, suggesting that the disorder is related to the presence of a structurally and functionally abnormal form of protein C. The propositus developed simultaneous warfarin-induced skin necrosis and bilateral adrenal hemorrhage. This is the first reported instance of warfarin-induced skin necrosis associated with a dysfunctional protein C molecule and the first reported instance of simultaneous warfarin-induced skin necrosis and bilateral adrenal hemorrhage.
authors.affiliation: Department of Medicine, University of Wisconsin, Madison 53706.
authors.forename: M G
authors.initials: MG
authors.lastname: Conlan
authors.forename: A
authors.initials: A
authors.lastname: Bridges
authors.forename: E
authors.initials: E
authors.lastname: Williams
authors.forename: R
authors.initials: R
authors.lastname: Marlar
mesh_terms: D000307:Adrenal Gland Diseases / Q000150:complications*; D006470:Hemorrhage / Q000150:complications*; D006801:Humans; D007123:Immunoelectrophoresis, Two-Dimensional; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011486:Protein C / Q000097:blood; D020151:Protein C Deficiency; D011488:Protein Deficiency / Q000145:classification / Q000150:complications / Q000235:genetics*; D012867:Skin / Q000473:pathology*; D014859:Warfarin / Q000009:adverse effects*
chemical_list: D011486:Protein C; D014859:Warfarin