Progressive Venous Thromboembolism And Warfarin-Induced Skin Necrosis On Background Diabetus Mellitus Type 2 In Combination With Accompanied Disease: A Clinical Case

Abstract

Background. Oral anticoagulants used in clinical practice in atrial fibrillation, deep vein thrombosis, pulmonary embolism (PE), as well as in heart valves protesis, heart thrombosis. Warfarin is the medicine with the largest evidence base and a long history of use more than 70 years. The optimal anticoagulant effect of warfarin is INR from 2,0-3,0 with 70% of measurements (TTR 70%). In one case there is a risk of ischemic stroke in non-compliance, in another - bleeding. Although cutaneous manifestations are rare, however, warfarin-induced skin necrosis is extremely dangerous. Present`s clinical case of progressive venous thromboembolism on the background of anticoagulant therapy in a 64-yearold woman with comorbid pathology. The described clinical, laboratory and instrumental data, that confirmed thrombotic and thromboembolic complications, which were ineffective in relation to the traditional anticoagulant strategy Aim: to describe a clinical case and analyze the challenges in diagnosing and treatment of progressive venous thromboembolism in a patient with concomitant diabetus mellitus type 2, obese,cirrhosis of liver , ineffective anticoagulants and developing warfarin skin necrosis. Materials and methods. The article presents the clinical case of pulmonary embolism, progressive venous thromboembolism in a 64- year -old woman with concomitant diabetus mellitus type 2, obese,cirrhosis of liver that was observed in IUC in the Hospital” Medbud’.