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Warfarin necrosis is a rare but severe complication of treatment with warfarin or related anticoagulants. [2] The typical patient appears to be an obese, middle aged woman (median age 54 years, male to female ratio 1:3). [1] [3]: 122–3 This drug eruption usually occurs between the third and tenth days of therapy with warfarin derivatives. [1]
Vitamin K 1-deficiency may occur by disturbed intestinal uptake (such as would occur in a bile duct obstruction), by therapeutic or accidental intake of a vitamin K 1-antagonist such as warfarin, or, very rarely, by nutritional vitamin K 1 deficiency. As a result, Gla-residues are inadequately formed and the Gla-proteins are insufficiently active.
Acquired causes of coagulopathy include anticoagulation with warfarin, liver failure, vitamin K deficiency and disseminated intravascular coagulation. Additionally, the hemotoxic venom from certain species of snakes can cause this condition, for example Bothrops, rattlesnakes and other species of viper.
Warfarin is indicated for the prophylaxis and treatment of venous thrombosis and its extension, pulmonary embolism; [9] prophylaxis and treatment of thromboembolic complications associated with atrial fibrillation and/or cardiac valve replacement; [9] and reduction in the risk of death, recurrent myocardial infarction, and thromboembolic events such as stroke or systemic embolization after ...
Petechia of the lower leg in a person with platelets of 3 due to ITP (immune thrombocytopenia).The most common cause of petechiae is through physical trauma such as a hard bout of coughing, holding breath, vomiting, or crying, which can result in facial petechiae, especially around the eyes.
An anticoagulant, commonly known as a blood thinner, is a chemical substance that prevents or reduces the coagulation of blood, prolonging the clotting time. [1] Some occur naturally in blood-eating animals, such as leeches and mosquitoes, which help keep the bite area unclotted long enough for the animal to obtain blood.
Supportive treatment is the only proven treatment method. Supplemental oxygen can be given if a person has mild respiratory distress. [ 6 ] However, if a person has severe respiratory distress, either continuous positive pressure ventilation (CPAP), or mechanical ventilation using positive end-expiratory pressure (PEEP) [ 5 ] may be indicated.
Protein C is vitamin K-dependent. Patients with Protein C deficiency are at an increased risk of developing skin necrosis while on warfarin. Protein C has a short half life (8 hour) compared with other vitamin K-dependent factors and therefore is rapidly depleted with warfarin initiation, resulting in a transient hypercoagulable state.