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warfarin 과량 사용후 발생한 Purple Toe 증후군과 동반된 급성 신부전 1예
박찬현,강경원,신진호,박한철,강종명,김상곰 대한신장학회 1995 Kidney Research and Clinical Practice Vol.14 No.4
Classically, purple toe syndrome is known to be an adverse effect of warfarin anticoagulant and it is due to direct cytotoxic effect of warfarin derivatives to capillary wall. But purple toe syndrome is recently said to be associated with cholesterol ernbolism which rr.ay be due to warfarinization and/or thrombolytic therapy and/or intraarterial procedure. In case of cholesterol embolism, acute renal failure is an omnious complication and usually irreversible. An 82-year old man visited us for painful both lower extremities and abdominal pain with dark colored stool. He had been on warfarinization for a month since the recent attack of cerebellar infarction. Inadvertently, he took his medicine excessively to relieve recently developed common cold. He developed a refractory renal failure associated with purple toe syndrome. Thirty nine days later, he died of renal failure. Although it was not confirmed by skin biopsy, the excessive warfarinization seems to be causally related to this purple toe syndrome.
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