Successful Warfarin Anticoagulation Despite Protein C Deficiency and a History of Warfarin Necrosis

Excerpt

Protein C deficiency is an autosomal-dominant disorder associated with recurrent thromboembolism (1). Prevention of the thromboembolic problems requires long-term anticoagulation, but the initiation of oral anti-coagulation therapy in patients with protein C deficiency may be complicated by skin necrosis (2). We present the case of a patient with protein C deficiency for whom anti-coagulation treatment with warfarin was successful, despite prior warfarin necrosis.

A 44-year-old man of Greek ancestry developed a left femoral artery thrombosis in 1981 after myelography. He was placed on treatment with warfarin without difficulty and continued the therapy for 8 months. In 1982 he developed right