title: Hypercoagulable state due to alcohol-paracetamol syndrome producing acute limb ischemia.
abstract: The authors describe a man with alcohol-paracetamol syndrome and hepatic failure who presented with acute arterial thrombosis of the left limb. The patient has jaundice, increased serum transaminase levels, and significant coagulopathy, with elevated international normalized ratio and prolonged prothrombin time. A transient hypercoagulable state due to liver failure is documented, characterized by acquired deficiencies of antithrombin III, protein C, and protein S. Laboratory and molecular testing for inherited hypercoagulable disorders during the follow-up period is positive for increased levels of factor VIII. The patient undergoes successful thrombectomy and receives intensive symptomatic and causal treatment, resulting in complete recovery. The patient is discharged 20 days after admission on a regimen of acenocoumarol.
authors: Department of Vascular Surgery, Red Cross Hospital, Athens, Greece. konmoulakakis@yahoo.gr
authors: Konstantinos G
authors: KG
authors: Moulakakis
authors: Giorgos
authors: G
authors: Sfyroeras
authors: Polivios
authors: P
authors: Pavlidis
authors: Nikolaos
authors: N
authors: Besias
authors: Dimitrios
authors: D
authors: Maras
authors: Vassilios
authors: V
authors: Andrikopoulos
mesh_terms: D000082:Acetaminophen / Q000506:poisoning*; D000431:Ethanol / Q000506:poisoning*; D006801:Humans; D007511:Ischemia / Q000139:chemically induced*; D007866:Leg / Q000098:blood supply*; D017114:Liver Failure, Acute / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D013577:Syndrome; D013927:Thrombosis / Q000139:chemically induced* / Q000601:surgery
chemical_list: D000082:Acetaminophen; D000431:Ethanol