title: A fatal case of enoxaparin induced skin necrosis and thrombophilia.
abstract: Skin necrosis caused by heparins is a rare complication. We report a case of a 71-yr-old white woman who developed painful diffuse skin lesions, most probably related to enoxaparin treatment. Other causes of skin necrosis, including heparin induced thrombocytopenia, disseminated intravascular coagulation, protein C/protein S deficiencies, anti-phospholipid antibodies, and vitamin K deficiency were less likely in this case. The concomitant combined thrombophilia possibly aggravated the patient's clinical presentation.
authors.affiliation: Department of Hematology and Bone Marrow Transplantation, Thrombosis and Hemostasis Unit, Rambam Medical Centre and Bruce Rappaport Faculty of Medicine, Haifa, Israel. ynadir@netvision.net.il
authors.forename: Yona
authors.initials: Y
authors.lastname: Nadir
authors.forename: Yoav
authors.initials: Y
authors.lastname: Mazor
authors.forename: Bergman
authors.initials: B
authors.lastname: Reuven
authors.forename: Galit
authors.initials: G
authors.lastname: Sarig
authors.forename: Benjamin
authors.initials: B
authors.lastname: Brenner
authors.forename: Norberto
authors.initials: N
authors.lastname: Krivoy
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects*; D003937:Diagnosis, Differential; D003875:Drug Eruptions / Q000209:etiology*; D017984:Enoxaparin / Q000009:adverse effects*; D005165:Factor V / Q000235:genetics; D005169:Factor VIII / Q000032:analysis; D017809:Fatal Outcome; D005260:Female; D050723:Fractures, Bone / Q000601:surgery; D020022:Genetic Predisposition to Disease; D006801:Humans; D009336:Necrosis; D011183:Postoperative Complications / Q000517:prevention & control; D011516:Prothrombin / Q000235:genetics; D013923:Thromboembolism / Q000517:prevention & control; D019851:Thrombophilia / Q000139:chemically induced* / Q000235:genetics
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin; C095381:factor V Leiden; D005165:Factor V; D011516:Prothrombin; D005169:Factor VIII