Open AccessSepsis as a cause of acquired Protein C and Protein S deficiency- A case report and literature review
Author(s) -
Arun Kannan,
Sweta Chandra,
José Manuel Del Casar Lizcano,
Charles E. Murphy
Publication year - 2014
Publication title -
journal of nepal medical association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.176
H-Index - 19
eISSN - 1815-672X
pISSN - 0028-2715
DOI - 10.31729/jnma.2296
Subject(s) - medicine , warfarin , sepsis , septic shock , protein c deficiency , protein s deficiency , protein c , complication , necrosis , pneumonia , surgery , protein s , intensive care medicine , thrombosis , venous thrombosis , atrial fibrillation
Warfarin Induced Skin Necrosis is a well-known complication in patients being started on warfarin without adequate bridging . The mechanism is thought to be due to protein C deficiency . We present a rather unusual cause of protein C deficiency due to sepsis resulting in warfarin induced skin necrosis. 43 year old lady who has been on chronic warfarin therapy secondary to anti phospholipid syndrome was admitted to the hospital for acute ischemic cerebellar stroke. Warfarin was held due to acute thrombocytopenia. She was discharged after restarting the warfarin. She presented back with septic shock due to pneumonia. She was found to have multiple necrotic areas consistent with skin necrosis. Unfortunately, patient died due to multi organ failure despite goal directed therapy. This case demonstrates the importance of recognizing the sepsis as an acquired cause of protein C deficiency.