| Summary points: | A previously healthy 50-year-old white male developed a deep vein thrombosis consequent to surgical placement of a titanium rod to correct a fracture of the femur; he was maintained for over 1 year on daily oral doses of coumadin 9 mg and aspirin 325 mg. He is referred by his primary care physician for life-long anticoagulation, a decision due to deficiencies of both protein C and protein S. Blood work and laboratory data are described. This case illustrates that coumadin was exerting a therapeutically acceptable negative influence on plasma activity levels of vitamin K-dependent protein C and protein S. |