PROGRESSIVE GANGRENE OF THE HAND FOLLOWING EXTRAVASATION OF ANTIBIOTICS ASSOCIATED WITH HEREDITARY RESISTANCE TO ACTIVATED PROTEIN-C

Protein C, a vitamin K-dependent potent anticoagulant, is synthesized in the liver. Hereditary resistance to activated protein C is a condit ion that increases the risk of thrombosis as a result of mutation in f actor V gene (factor V Leiden). It is generally accepted to be associa ted with venous thrombosis. We present a patient who was given antibio tics via the dorsal hand veins. Venous thrombosis in the hand that ens ued from the extravasation of antibiotics resulted in the formation of arterial thrombosis that eventually lead to necrosis. Factor V gene a nalysis showed that the patient was heterozygous for the common factor V arginine(506) to glutamine mutation. To the best of our knowledge, hand necrosis due to antibiotic extravasation associated with heredita ry resistance to activated protein C has not been reported previously.