Key result
Warfarin therapy in a patient with protein S deficiency and an MTHFR mutation led to the development of abdominal skin necrosis within 4 days.
Case Report (n=1)
This is the first reported case of warfarin skin necrosis associated with a methylenetetrahydrofolate reductase mutation and protein S deficiency.
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Suggests possible early warfarin necrosis risk in protein S deficiency with MTHFR mutation; first case extends observations but leaves association open.
The use of warfarin is rarely complicated by skin necrosis. We describe a 50-year-old woman who presented with a left leg deep venous thrombosis and subsequent pulmonary embolism. She was initially anticoagulated with low-molecular weight heparin and subsequently warfarin. Within 4 days abdominal skin necrosis developed. Investigations revealed the presence of protein S deficiency and in addition, a mutation in the methylenetetrahydrofolate reductase gene (MTHFR). We present, to our best knowledge, the first case of warfarin skin necrosis associated with a methylenetetrahydrofolate reductase mutation.
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Byrne et al. (2004) conducted a case report in Deep venous thrombosis and pulmonary embolism (n=1). Warfarin was evaluated on Abdominal skin necrosis. Warfarin therapy in a patient with protein S deficiency and an MTHFR mutation led to the development of abdominal skin necrosis within 4 days.
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