Coumadin®-lnduced Necrosis of Breast, Disseminated Intravascular Coagulation, and Hemolytic Anemia
Authors: MARIO-ANTOINE DICATO
Journal: Annals of Internal Medicine (1975)

Letters1 August 1975Coumadin®-lnduced Necrosis of Breast, Disseminated Intravascular Coagulation, and Hemolytic AnemiaMARIO-ANTOINE DICATO, M.D., LEONARD ELLMAN, M.D.MARIO-ANTOINE DICATO, M.D.Search for more papers by this author, LEONARD ELLMAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-83-2-233 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe development of infarction and necrosis of the skin and subcutaneous tissue is an uncommon complication of anticoagulant therapy with coumarin derivatives. We have recently cared for a patient with bilateral breast necrosis due to sodium warfarin (Coumadin®) whose illness was complicated by disseminated intravascular coagulation and microangiopathic hemolytic anemia. Although intravenous heparin has been reported to be of value in the treatment of coumarin necrosis (1, 2), we are unaware of any previous case in which disseminated intravascular coagulation has been documented. We present here a case in which bilateral breast necrosis occurred after the use of sodium warfarin...References1. BELLER F: Therapie der sogenannten "Cumarin Nekrosen." Med Bilddienst 4:116-118, 1961 Google Scholar2. NALBANDIANBELLERKAMP RFA: Coumarin necrosis of skin treated successfully with heparin. Obstet Gynecol 38:395-399, 1971 MedlineGoogle Scholar3. LIEB L: Uber die Kumarinnekrose und ihre Beziehung zum Schwartzman-Sanarelli-Phänomen. Zbl Chir 89:81-90, 1964 MedlineGoogle Scholar4. HJORTRAPPAPORTJORGENSON PSL: Purpura fulminans. Report of a case successfully treated with heparin and hydrocortisone. Review of 50 cases from the literature. Scand J Haematol 1:169-192, 1964 CrossrefMedlineGoogle Scholar5. GOODTHOMAS RL: Studies on the generalized Shwartzman reaction. IV. Prevention of the local and generalized Shwartzman reactions with heparin. J Exp Med 97:871-888, 1953 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: MARIO-ANTOINE DICATO, M.D.; LEONARD ELLMAN, M.D.Affiliations: Hematology Unit Massachusetts General Hospital Boston, Massachusetts 02114 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCoumarin anticoagulantsANTICOAGULANTS, THROMBOLYTIC AGENTS, AND ANTI-PLATELET DRUGSA Gut Reaction?Coumarin anticoagulantsWarfarin-Induced Skin NecrosisWarfarin-induced complete bilateral breast necrosisCoagulopathy and warfarin-associated breast necrosis in a patient with a primary brain tumorWarfarin skin necrosis treated with prostacyclinVollständige Reversibilität einer beginnenden Kumarin-Nekrose unter fibrinolytischer Therapie nach Thrombose bei partiellem (heterozygotem) Protein-C-MangelDermatologic Problems in the Intensive Care Unit: Part IVCoumarin induced acral skin necrosis associated with hereditary protein C deficiencyDrugs affecting blood clotting and fibrinolysisHeparin Therapy in Coumadin® Breast NecrosisDAVID TONG, M.B., B.S., D.M.R.T.“Purple Toes” Syndrome 1 August 1975Volume 83, Issue 2Page: 233-234KeywordsAnticoagulant therapyCoumarinsDisseminated intravascular coagulationHemolytic anemiaHeparinInfarctionNecrosisSodium ePublished: 1 December 2008 Issue Published: 1 August 1975 PDF downloadLoading ...