Abstract
Hemostatic physiology involves a complex interlinking of blood and endothelial factors. Its pharmacological manipulation invariably impacts at multiple molecular sites. Herein is reported an unusual case of coexistent warfarin-induced skin necrosis and heparin-induced thrombocytopenia following mitral valve replacement for thromboembolic phenomena associated with marantic endocarditis and bronchial adenocarcinoma. Thrombophilia in the face of endocarditis should be treated with a suspicion of underlying cancer.
MeSH terms
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Adenocarcinoma / complications
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Adenocarcinoma / pathology
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Anticoagulants / adverse effects*
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Bronchial Neoplasms / complications
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Bronchial Neoplasms / pathology
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Endocarditis / surgery*
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Fatal Outcome
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Heart Valve Diseases / surgery
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Heart Valve Prosthesis Implantation*
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Heparin / adverse effects*
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Humans
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Intracranial Embolism / drug therapy
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Intracranial Embolism / etiology
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Male
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Middle Aged
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Mitral Valve / surgery*
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Necrosis / chemically induced
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Postoperative Complications / etiology
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Skin / drug effects
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Skin / pathology*
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Thrombocytopenia / chemically induced*
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Warfarin / adverse effects*
Substances
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Anticoagulants
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Warfarin
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Heparin