. . "0032-6739" . "Warfarinem indukovan\u00E1 nekr\u00F3za k\u016F\u017Ee" . "1"^^ . . . "2"^^ . "I" . "[3B379487BA19]" . "Warfarinem indukovan\u00E1 nekr\u00F3za k\u016F\u017Ee"@cs . "93" . . "RIV/00064203:_____/13:10196240" . . . "Havl\u00EDn, Jan" . . "RIV/00064203:_____/13:10196240!RIV14-MZ0-00064203" . "5" . "3"^^ . "Nekr\u00F3za k\u016F\u017Ee je vz\u00E1cnou, nicm\u00E9n\u011B z\u00E1va\u017Enou komplikac\u00ED peror\u00E1ln\u00ED antikoagula\u010Dn\u00ED terapie warfarinem. Je zp\u016Fsobena rozs\u00E1hlou tromb\u00F3zou postkapil\u00E1rn\u00EDch venul v podko\u017En\u00EDm tuku, nej\u010Dast\u011Bji u jedinc\u016F s trombofiln\u00ED predispozic\u00ED. Patogeneze nekr\u00F3zy je vysv\u011Btlov\u00E1na dysbalanc\u00ED koagula\u010Dn\u00EDch a antikoagula\u010Dn\u00EDch faktor\u016F. Nejv\u00FDznamn\u011Bj\u0161\u00EDm protektivn\u00EDm \u00FA\u010Dinkem warfarinu je inhibice karboxylace fakoru II - protrombinu. Warfarin v\u0161ak inhibuje i antikoagula\u010Dn\u00ED proteiny C a S. Polo\u010Das faktoru II se pohybuje mezi 60-72 h, zat\u00EDmco polo\u010Das proteinu C je 9 h, tak dojde k p\u0159echodn\u00E9mu hyperkoagula\u010Dn\u00EDmu stavu vedouc\u00EDmu ke ko\u017En\u00ED nekr\u00F3ze. V kazuistice prezentujeme p\u0159\u00EDpad 60let\u00E9ho mu\u017Ee po n\u00E1hrad\u011B aort\u00E1ln\u00ED chlopn\u011B, u kter\u00E9ho se 8 dn\u00ED po zahajen\u00ED antikoagula\u010Dn\u00ED l\u00E9\u010Dby warfarinem objevily ko\u017En\u00ED nekr\u00F3zy na doln\u00EDch kon\u010Detin\u00E1ch, kter\u00E9 vymizely po p\u0159eveden\u00ED na l\u00E9\u010Dbu n\u00EDzkomolekul\u00E1rn\u00EDm heparinem. Hematologick\u00E9 a genetick\u00E9 vy\u0161et\u0159en\u00ED neprok\u00E1zalo vrozen\u00FD hyperkoagula\u010Dn\u00ED stav." . . "Warfarinem indukovan\u00E1 nekr\u00F3za k\u016F\u017Ee"@cs . . . "Nekr\u00F3za k\u016F\u017Ee je vz\u00E1cnou, nicm\u00E9n\u011B z\u00E1va\u017Enou komplikac\u00ED peror\u00E1ln\u00ED antikoagula\u010Dn\u00ED terapie warfarinem. Je zp\u016Fsobena rozs\u00E1hlou tromb\u00F3zou postkapil\u00E1rn\u00EDch venul v podko\u017En\u00EDm tuku, nej\u010Dast\u011Bji u jedinc\u016F s trombofiln\u00ED predispozic\u00ED. Patogeneze nekr\u00F3zy je vysv\u011Btlov\u00E1na dysbalanc\u00ED koagula\u010Dn\u00EDch a antikoagula\u010Dn\u00EDch faktor\u016F. Nejv\u00FDznamn\u011Bj\u0161\u00EDm protektivn\u00EDm \u00FA\u010Dinkem warfarinu je inhibice karboxylace fakoru II - protrombinu. Warfarin v\u0161ak inhibuje i antikoagula\u010Dn\u00ED proteiny C a S. Polo\u010Das faktoru II se pohybuje mezi 60-72 h, zat\u00EDmco polo\u010Das proteinu C je 9 h, tak dojde k p\u0159echodn\u00E9mu hyperkoagula\u010Dn\u00EDmu stavu vedouc\u00EDmu ke ko\u017En\u00ED nekr\u00F3ze. V kazuistice prezentujeme p\u0159\u00EDpad 60let\u00E9ho mu\u017Ee po n\u00E1hrad\u011B aort\u00E1ln\u00ED chlopn\u011B, u kter\u00E9ho se 8 dn\u00ED po zahajen\u00ED antikoagula\u010Dn\u00ED l\u00E9\u010Dby warfarinem objevily ko\u017En\u00ED nekr\u00F3zy na doln\u00EDch kon\u010Detin\u00E1ch, kter\u00E9 vymizely po p\u0159eveden\u00ED na l\u00E9\u010Dbu n\u00EDzkomolekul\u00E1rn\u00EDm heparinem. Hematologick\u00E9 a genetick\u00E9 vy\u0161et\u0159en\u00ED neprok\u00E1zalo vrozen\u00FD hyperkoagula\u010Dn\u00ED stav."@cs . "http://www.prolekare.cz/prakticky-lekar-clanek/warfarinem-indukovana-nekroza-kuze-41739" . "CZ - \u010Cesk\u00E1 republika" . . . . "proteins C and S; skin necrosis; warfarin"@en . "Praktick\u00FD l\u00E9ka\u0159" . "Skin necrosis is a rare but serious complication of oral anticoagulant therapy with warfarin. It is caused by extensive thrombosis of postcapillary venules in the subcutaneous fat, most often in individuals with thrombophilia. Pathogenesis of necrosis is explained by an imbalance of coagulation and anticoagulation factors. The most significant protective effect of warfarin is the inhibition of carboxylation of prothrombin. However warfarin also inhibits the anticoagulant proteins C and S. The half-time of factor II is 60-72 hours, while the half-time of protein C is 9 hours, so there is a temporary hypercoagulation leading to skin necrosis. In the case report we present a 60-year-old man after aortic valve replacement. 8 days after the initiation of anticoagulation therapy with warfarin skin necrosis occurred in the lower limbs, which disappeared after switching to treatment of low molecular weight heparin. Hematologic and genetic examinations did not reveal any congenital hypercoagulable state."@en . "Chlumsk\u00FD, Jarom\u00EDr" . "117086" . "Warfarin skin necrosis without protein S, protein C deficiency or other procoagulant state"@en . "Warfarinem indukovan\u00E1 nekr\u00F3za k\u016F\u017Ee" . "Warfarin skin necrosis without protein S, protein C deficiency or other procoagulant state"@en . .