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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.
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.
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 ...
One common definition of thrombocytopenia requiring emergency treatment is a platelet count below 50,000/μL. [5] Thrombocytopenia can be contrasted with the conditions associated with an abnormally high level of platelets in the blood – thrombocythemia (when the cause is unknown), and thrombocytosis (when the cause is known). [6] [7]
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.
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.
Petechiae are seen on the chest, axilla, shoulder, and mouth. [5] Occulsion of dermal capillaries by the fat emboli result in petechial rash. Petechiae rash occurs in 50 to 60% of the cases. [7] Neurologic signs such as confusion, stupor, and coma may be present. These are usually temporary and do not happen on one side of the body.