leftfoot
Forum Elite
Topics: 29
Posts: 216
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purple toe syndrome occurs sometimes when patient is put on warferin.
it is related to transient protien C deficiency.....
can someone explain the mechanism behid it?
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| meg
Forum Guru
Topics: 62
Posts: 806
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Vit K dependent coagulation factors are 2, 7, 9, 10 and Protein C and S. Among these Protein C and 7 have the shortest t-1/2 (in that same order). So when warfarin is given, protein C goes out first. Protein C normally prevents thromboses. It is activated by thrombomodulin and inhibits thrombin formation and has fibrinolytic effects. So in its absence, there will be thrombosis.
Hence, initially on giving warfarin, there is thrombosis in the patient!! just the opposite of what we wanted! But then as 7, 2, 9, 10 go out, then we get the desired effect.
the ischaemia of the toes is due to thrombosis.
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| leftfoot
Forum Elite
Topics: 29
Posts: 216
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...so it means that vit K is responsible for production of not only clotting factors but also anti thrombotic agents( protein C and protein S), right!
thanks meg! i think i got the concept!
:wink:
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| Idiopathic
Forum Guru
Topics: 19
Posts: 641
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Vitamin K is not responsible for the production of these factors, but rather their activation, through gamma-carboxylation. The factors are made by the liver, vitamin K is absorbed in the gut, and the factors are activated.
I think a major symptom of protein C deficiency is sloughing of the skin due to necrosis after warfarin administration.
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oh yes...you are right!
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