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• W2052598699 abstract "The cause of cancer-associated venous limb gangrene is unknown but could paradoxically be due to warfarin.To determine the pathogenesis of venous gangrene in a patient with cancer.Case report.University hospital in Ontario, Canada.66-year-old woman with metastatic lung cancer and deep venous thrombosis.Levels of vitamin K-dependent factors, additional coagulation factors, and thrombin-antithrombin complexes (marker of thrombin generation).During warfarin use, venous limb gangrene developed when the international normalized ratio (INR) reached 6.0 (therapeutic range, 2.0 to 3.0); at this time, the level of protein C (a vitamin K-dependent natural anticoagulant) was severely reduced, but thrombin-antithrombin complexes remained markedly elevated. The supratherapeutic INR was explained by the greatly reduced levels of factor VII, which correlated closely with protein C levels; therefore, the high INR was a surrogate marker for severely reduced protein C activity.Warfarin may contribute to the pathogenesis of cancer-associated venous limb gangrene by leading to severe depletion of protein C while at the same time failing to reduce thrombin generation." @default.
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• W2052598699 date "2001-10-16" @default.
• W2052598699 modified "2023-09-27" @default.
• W2052598699 title "Venous Limb Gangrene during Warfarin Treatment of Cancer-Associated Deep Venous Thrombosis" @default.
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• W2052598699 doi "https://doi.org/10.7326/0003-4819-135-8_part_1-200110160-00009" @default.
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