title: Warfarin-induced skin necrosis and heparin-induced thrombocytopenia following mitral valve replacement for marantic endocarditis.
abstract: Hemostatic physiology involves a complex interlinking of blood and endothelial factors. Its pharmacological manipulation invariably impacts at multiple molecular sites. Herein is reported an unusual case of coexistent warfarin-induced skin necrosis and heparin-induced thrombocytopenia following mitral valve replacement for thromboembolic phenomena associated with marantic endocarditis and bronchial adenocarcinoma. Thrombophilia in the face of endocarditis should be treated with a suspicion of underlying cancer.
authors.affiliation: King's College Hospital, London, UK. Michael.marrinan@kingsch.nhs.uk
authors.forename: Craig A
authors.initials: CA
authors.lastname: White
authors.forename: Darryl A
authors.initials: DA
authors.lastname: Chung
authors.forename: Martyn
authors.initials: M
authors.lastname: Thomas
authors.forename: Michael T
authors.initials: MT
authors.lastname: Marrinan
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000473:pathology; D000925:Anticoagulants / Q000009:adverse effects*; D001984:Bronchial Neoplasms / Q000150:complications / Q000473:pathology; D004696:Endocarditis / Q000601:surgery*; D017809:Fatal Outcome; D006349:Heart Valve Diseases / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D020766:Intracranial Embolism / Q000188:drug therapy / Q000209:etiology; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D009336:Necrosis / Q000139:chemically induced; D011183:Postoperative Complications / Q000209:etiology; D012867:Skin / Q000187:drug effects / Q000473:pathology*; D013921:Thrombocytopenia / Q000139:chemically induced*; D014859:Warfarin / Q000009:adverse effects*
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D006493:Heparin