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

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▸Requests for reprints should be addressed to N. Peter Zauber, M.D.; 22 Old Short Hills Road; Livingston, NJ 07039.

St. Barnabas Medical Center; Livingston, New Jersey

© 1986 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1986;104(5):659-660. doi:10.7326/0003-4819-104-5-659
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This excerpt has been provided in the absence of an abstract.

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


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