Abstract
The prothrombin time/International Normalized Ratio is an accurate parameter for following most warfarin-treated patients. However, it reflects mostly factor VII levels, and significant disproportionate alterations in other vitamin K-dependent factors may not be reflected properly. We report a rare case of a woman who developed arterial thrombosis whilst receiving therapeutic doses of warfarin, and was found to have a significant and unbalanced protein S deficiency. Discontinuation of warfarin resulted in complete normalization of coagulation factors, and no further thrombotic events under treatment with enoxaparin, with a follow-up of 2.5 years.
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