{"id":7543,"date":"2022-11-22T13:00:22","date_gmt":"2022-11-22T10:00:22","guid":{"rendered":"https:\/\/urbancare.clinic\/warfarin-induced-skin-necrosis\/"},"modified":"2023-05-23T17:37:36","modified_gmt":"2023-05-23T14:37:36","slug":"necrosi-cutanea-indotta-dal-warfarin","status":"publish","type":"post","link":"https:\/\/urbancare.clinic\/it\/warfarin-induced-skin-necrosis\/","title":{"rendered":"Necrosi cutanea indotta da warfarin"},"content":{"rendered":"
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Fonte quotidiana medica<\/a><\/p>\n

","protected":false},"excerpt":{"rendered":"

Il warfarin, una doppia spada, non solo aiuta nell'anticoagulazione inibendo i fattori della coagulazione dipendenti dalla vitamina K, ma previene anche la lisi del coagulo inibendo la proteina C e la proteina S. L'emivita delle proteine C e S \u00e8 pi\u00f9 breve di quella dei fattori della coagulazione dipendenti dalla vitamina K, quindi la sua la concentrazione plasmatica diminuisce pi\u00f9 velocemente. Se iniziato da solo, il paziente \u00e8 a rischio di sviluppare necrosi cutanea indotta da warfarin, una complicanza potenzialmente disastrosa sebbene rara (0,01%-0,1%) che di solito si verifica 2-5 giorni dopo l'inizio della terapia con warfarin.<\/p>\n

Un uomo di 63 anni a cui \u00e8 stata recentemente diagnosticata una cardiopatia reumatica con grave stenosi mitralica presentava un'anamnesi di diminuzione della produzione di urina da 2 giorni. Ha iniziato ad assumere compresse di warfarin 5 mg una volta al giorno e compresse di furosemide 20 mg due volte al giorno 2 settimane fa. L'esame obiettivo ha mostrato una frequenza cardiaca di 98 bpm, una pressione sanguigna di 140\/88 mm Hg, una frequenza respiratoria di 26 respiri\/min. L'auscultazione cardiaca mostrava ritmo irregolare\u2026.<\/p>","protected":false},"author":2,"featured_media":7544,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"page_builder":"","fifu_image_url":"https:\/\/urbancare.clinic\/wp-content\/uploads\/2023\/02\/warfarin-induced-skin-necrosis.jpg","fifu_image_alt":"","footnotes":""},"categories":[185],"tags":[198],"class_list":["post-7543","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-research-medical-articles","tag-blood-pressure"],"yoast_head":"\nWarfarin induced skin necrosis - Urban Care Clinic<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/urbancare.clinic\/it\/necrosi-cutanea-indotta-dal-warfarin\/\" \/>\n<meta property=\"og:locale\" content=\"it_IT\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Warfarin induced skin necrosis - Urban Care Clinic\" \/>\n<meta property=\"og:description\" content=\"Warfarin, a double sword not only helps in anticoagulation by inhibition of vitamin K dependent clotting factors but also prevents clot lysis by inhibiting protein C and protein S. The half-life of protein C and S is shorter than vitamin K dependent clotting factors hence its plasma concentration falls faster. If started alone the patient is at risk of developing warfarin induced skin necrosis, a potentially disastrous although a rare complication (0.01%–0.1%) usually occurring 2–5 days after initiation of warfarin therapy. A 63-year-old man recently diagnosed rheumatic heart disease with severe mitral stenosis presented with a 2-day history of decreased urine output. He was started on tablet warfarin 5 mg once a day and tablet furosemide 20 mg two times a day 2 weeks ago. Physical examination showed pulse rate of 98 bpm, blood pressure of 140\/88 mm Hg, respiratory rate of 26 breaths\/min. 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