Recurrent coumarin necrosis in a patient with heterozygous protein S defici
ency type II Coumarin necrosis is a rare but clinical very important compli
cation of therapy,with coumarin derivatives. We report a patient with conge
nital protein S deficiency type II; who developed coumarin necrosis during
stabilization of phenoprocoumon. Diagnostic problems and therapeutic altern
atives are discussed considering the recent literature.