title: Skin necrosis: a rare complication of protein S deficiency.
abstract: Hereditary protein S deficiency is an autosomal dominant disorder leading to recurrent venous thrombosis and, less commonly, to arterial thrombosis. Cases of skin necrosis have been documented in patients with protein C or S deficiency while being treated with warfarin. We describe herein a patient with protein S deficiency who developed significant skin necrosis without being exposed to warfarin. She had a protracted clinical course resulting in gangrene and transmetatarsal amputation. Recognition of this rare complication and an earlyhematology referral may prevent dismal outcomes in patients with protein S deficiency.
authors.affiliation: Department of Hospital Medicine, Saint Francis Hospital and Medical Center, Hartford, USA. drasif00@yahoo.co.in
authors.forename: Ashif
authors.initials: A
authors.lastname: Jethava
authors.affiliation: Department of Pathology, Saint Francis Hospital and Medical Center, Hartford, USA.
authors.forename: Thalia
authors.initials: T
authors.lastname: Mesologites
authors.affiliation: Department of Hospital Medicine, Saint Francis Hospital and Medical Center, Hartford, USA.
authors.forename: Syed
authors.initials: S
authors.lastname: Ali
authors.affiliation: Department ofHematology-Oncology, Saint Francis Hospital and Medical Center, Hartford, USA.
authors.forename: Constantin A
authors.initials: CA
authors.lastname: Dasanu
mesh_terms: D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications / Q000453:epidemiology; D008875:Middle Aged; D009336:Necrosis; D011486:Protein C / Q000032:analysis*; D018455:Protein S Deficiency / Q000150:complications* / Q000453:epidemiology; D012867:Skin / Q000473:pathology*; D012872:Skin Diseases, Vesiculobullous / Q000453:epidemiology / Q000209:etiology*; D012907:Smoking / Q000453:epidemiology
chemical_list: D011486:Protein C