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DOI: 10.1055/s-0038-1661286
Defibrination During Warfarin Therapy in a Man with Protein C Deficiency
Publikationsverlauf
Received 29. November 1984
Accepted 03. Februar 1985
Publikationsdatum:
18. Juli 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00035024/198502/lookinside/thumbnails/10-1055-s-0038-1661286-1.jpg)
Summary
A 57 year old man presented with apparently spontaneous lower extremity deep vein thrombosis and pulmonary embolism. He was treated in conventional fashion with intravenous heparin and oral warfarin. After 4 daily doses of warfarin the prothrombin and proconvertin (P+P) time was within therapeutic range, and heparin was stopped. Over the next six hours complete defibrination occurred, associated with severe bleeding complications. Functional protein C measured after normalization of routine coagulation tests averaged 40% of normal, and was only 3.5% of normal immediately prior to the episode of defibrination. We conclude that the very low functional protein C levels seen immediately prior to defibrination were caused by a combination of pre-existent protein C deficiency and warfarin therapy, and directly predisposed to defibrination once heparin was stopped, despite “therapeutic” warfarin anticoagulation. Exacerbation of intravascular coagulation should be considered a potential prothrombotic effect of warfarin therapy in protein C deficient individuals.
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