Unbalanced protein S deficiency due to warfarin treatment as a possible cause for thrombosis

Summary The prothrombin time/International Normalized Ratio is an accurate parameter for following most warfarin‐treated patients. However, it reflects mostly factor VII levels, and significant disproportionate alterations in other vitamin K‐dependent factors may not be reflected properly. We report...

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Published in:British journal of haematology 2007-10, Vol.139 (2), p.310-311
Main Authors: Haran, Michal Z., Lichman, Inna, Berebbi, Alain, Weinmann, Eran, Rosenberg, Nurit
Format: Article
Language:English
Subjects:
anticoagulants
Anticoagulants - adverse effects
Anticoagulants - therapeutic use
Biological and medical sciences
coagulation factors
Enoxaparin - therapeutic use
Female
Follow-Up Studies
Hematologic and hematopoietic diseases
Humans
International Normalized Ratio
Medical sciences
Middle Aged
Platelet diseases and coagulopathies
Protein S Deficiency - blood
thrombosis
Thrombosis - blood
Thrombosis - etiology
Thrombosis - prevention & control
Warfarin - adverse effects
Warfarin - therapeutic use
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Summary:Summary The prothrombin time/International Normalized Ratio is an accurate parameter for following most warfarin‐treated patients. However, it reflects mostly factor VII levels, and significant disproportionate alterations in other vitamin K‐dependent factors may not be reflected properly. We report a rare case of a woman who developed arterial thrombosis whilst receiving therapeutic doses of warfarin, and was found to have a significant and unbalanced protein S deficiency. Discontinuation of warfarin resulted in complete normalization of coagulation factors, and no further thrombotic events under treatment with enoxaparin, with a follow‐up of 2.5 years.
ISSN:0007-1048
1365-2141
DOI:10.1111/j.1365-2141.2007.06784.x