Zusammenfassung
Die Inzidenz der sogenannten Kumarinnekrose wird auf 0,01–0,1% geschätzt [3, 15]. Besonders gefährdet sind Patienten, die die Verminderung eines Gerinnungsinhibitors aufweisen. Zahlreiche Kasuistiken belegen die Koinzidenz von Protein C-Mangel und Hautnekrose unter der oralen Antikoagulation [2, 10, 14, 16, 17, 20, 22, 24, 25, 27]. In der überwiegenden Zahl der Fälle handelte es sich dabei um den heterozygoten Protein C-Mangel vom Typ I. Schwere Hautnekrosen in der initialen Behandlungsphase mit Kumarin wurden aber auch beim homozygoten Protein C-Mangel [5] sowie bei einem abnormen Protein C-Molekül [6] beschrieben. Scheffler et al [23] beobachteten eine Kumarinnekrose bei einer Patientin mit hereditärem Antithrombin III-Mangel.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Literatur
Anderson DR, Brill-Edwards P, Walker I (1992) Warfarin-induced skin necrosis in 2 patients with protein S deficiency: Successful reinstatement of warfarin therapy. Haemostasis 22: 124–128
Broekmans AW, Bertina RM, Lölinger EA et al (1983) Protein C and the development of skin necrosis during anticoagulant therapy. Thromb Haemost 49: 251
Cole MS, Minifee PK, Wolma FJ (1988) Coumarin necrosis. A review of the literature. Surgery 103: 271–277
Colman RW, Rao AK, Rubin RN (1993) Warfarin skin necrosis in a 33-year-old woman. Am J Hematol 43: 300–303
Conard J, Horellou MH, Dreden P van et al (1992) Homozygous protein C deficiency with late onset and recurrent coumarin-induced skin necrosis. Lancet 339: 743–744
Conlan MG, Bridges A, Williams E, Marlar R (1988) Familial type II protein C deficiency associated with warfarin-induced skin necrosis and bilateral adrenal hemorrhage. Am J Hematol 29: 226–229
Craig A, Taberner DA, Fisher AH et al (1990) Type I protein S deficiency and skin necrosis. Postgrad Med J 66: 389–391
Fair DS, Revak DJ (1984) Quantitation of human protein S in the plasma of normal and warfarin-treated individuals by radioimmunoassay. Thromb Res 36: 527–535
Friedman KD, Marlar RA, Houston JG, Montgomery RR (1986) Warfarin-induced skin necrosis in a patient with protein S deficiency (abstract). Blood 68: 333 a
Gladson CL, Groncy P, Griffin JH (1987) Coumarin necrosis, neonatal purpura fulminans, and protein C deficiency. Arch Dermatol 123: 1701–1706
Goldberg SL, Orthner CL, Yalisove BL et al (1991) Skin necrosis following prolonged administration of coumarin in a patient with inherited protein S deficiency. Am J Hematol 38: 64–66
Grimaudo V, Gueissaz F, Hauert J et al (1989) Coumarin-induced skin necrosis irt a pro-tein S deficient patient. Br Med J 298: 233–234
Kant KS, Glueck HI, Coots MC, Tonne VA, Brubaker R, Penn I (1992) Protein S deficiency and skin necrosis associated with continuous ambulatory peritoneal dialysis. Am J Kid Dis 19: 264–271
Kemkes-Matthes B, Heinrich D, Dapper F, Lasch HG (1988) Kumarinnekrose bei Protein C-Mangel. Med Welt 39: 72–75
Koch-Weser J (1968) Coumarin necrosis. Ann Intern Med 68: 1365
Locht H, Lindström FD (1993) Severe skin necrosis following warfarin therapy in a patient with protein C deficiency. J Int Med 233: 287–289
McGehee WG, Klotz TA, Eppstein DJ, Rapaport SI (1984) Coumarin necrosis associated with hereditary protein C-deficiency. Ann Intern Med 101: 59–60
Moreb J, Craig S, Kitchens CS (1989) Acquired functional protein S deficiency, cerebral venous thrombosis, and coumarin skin necrosis in association with antiphospholipid syndrome: Report of two cases. Am J Med 87: 207–210
Nalbandian RM, Mader I J, Barrett JL et al (1965) Petechiae, ecchymoses, and necrosis of skin induced by coumarin congeners. J Am Med Ass 1992: 603
Pabinger I, Karnik R, Lechner K, Slany J, Niessner H (1986) Coumarin induced acral skin necrosis associated with hereditary protein C deficiency. Blut 52: 365–370
Pabinger-Fasching I, Lechner K, Niessner H et al (1987) Protein C- and coagulation fac-tor levels during the initial phase of oral anticoagulant therapy (low dose regimen) in a patient with hererozygous protein C deficiency. Thromb Res 47: 705–708
Samama M, Horellou MH, Soria et al (1984) Succesful progressive anticoagulation in a severe protein C deficiency and previous skin necrosis at the initiation of oral anticoa-gulant treatment. Thromb Haemost 51: 132–33
Scheffler P, Kiehl R, Braun B, Hellstern P, Wenzel E (1988) Thromboembolische Kom-plikationen und Cumarin-Nekrose bei einer Patientin mit angeborenem Antithrombin III-Mangel. Internist 29: 54–57
Teepe RGC, Broekmans AW, Vermeer BJ et al (1986) Recurrent coumarin-induced skin necrosis in a patient with an acquired functional protein C deficiency. Arch Dermatol 122: 1408–1412
Wagner T, Schwieder G, Wiedemann G (1987) Kumarinnekrose und Protein C. Med Welt 38: 491–494
Wankmüller H, Eilbrück D, Seifried E (1991) Pathophysiologic, Klinik und Therapie der Cumarin-Nekrose. Dtsch Med Wochenschr 116: 1322–1330
Zauber NP, Stark MW (1986) Successful warfarin anticoagulation despite protein C deficiency and a history of warfarin necrosis. Ann Intern Med 104: 659–660
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1994 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Hach-Wunderle, V., Miller, A., Winckelmann, G. (1994). Orale Antikoagulation bei kombiniertem Protein S- und Protein C-Mangel und Kumarinnekrose. In: Scharrer, I., Schramm, W. (eds) 24. Hämophilie-Symposion. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-79009-6_58
Download citation
DOI: https://doi.org/10.1007/978-3-642-79009-6_58
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-57999-1
Online ISBN: 978-3-642-79009-6
eBook Packages: Springer Book Archive