A Case of Diffuse Alveolar Hemorrhage Due to Uncontrolled Warfarin Therapy

2012 ◽  
Vol 11 (2) ◽  
pp. 130-132 ◽  
Author(s):  
Turker Yardan ◽  
Ali Kemal Erenler ◽  
Selim Genc ◽  
Hizir Ufuk Akdemir
Keyword(s):  
Warfarin Therapy ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage

A life-threatening complication of warfarin therapy in ED: diffuse alveolar hemorrhage

2014 ◽  
Vol 32 (6) ◽  
pp. 690.e3-690.e4 ◽  
Author(s):  
Emin Uysal ◽  
Erdem Çevik ◽  
Süleyman Solak ◽  
Yahya Ayhan Acar ◽  
Mustafa Yalimol
Keyword(s):  
Warfarin Therapy ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
Life Threatening ◽  
Life Threatening Complication

scholarly journals Successful management of warfarin-exacerbated diffuse alveolar hemorrhage using an extracorporeal membrane oxygenation

2013 ◽  
Vol 8 ◽  
Author(s):  
Jong Hoo Lee ◽  
Su Wan Kim
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Warfarin Therapy ◽  
Ventilatory Support ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
Vein Thrombosis ◽  
Membrane Oxygenation ◽  
Threatening Condition ◽  
Life Threatening ◽  
Chest X Ray

Although diffuse alveolar hemorrhage complicating warfarin therapy is rare, it generally has a worsening clinical course and can be a life threatening condition. A 56-year-old male who had undergone a pulmonary lobectomy for lung cancer 2 years before had received warfarin for about 5 months due to pulmonary vein thrombosis. The patient presented with severe dyspnea and had prolonged anticoagulation values. Chest X-ray and computed tomography revealed diffuse pulmonary consolidations, and bronchoalveolar lavage demonstrated diffuse alveolar hemorrhage. The reversal of anticoagulation was initiated, and extracorporeal membrane oxygenation was performed for refractory respiratory failure that did not improve despite maximal mechanical ventilatory support. The diffuse alveolar infiltrations resolved after 5 days, and we successfully weaned off both extracorporeal membrane oxygenation and mechanical ventilation. Herein we report the detailed course of a case that was successfully treated with extracorporeal membrane oxygenation as a bridge-to-recovery for warfarin- exacerbated diffuse alveolar hemorrhage.

scholarly journals A rare case of Diffuse Alveolar Hemorrhage (DAH) due to warfarin toxicity

2020 ◽  
Vol 58 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Solmaz Borjian ◽  
Nasim Hakkak ◽  
Mohammad Amin Borjian
Keyword(s):  
Clinical Condition ◽  
Respiratory Symptoms ◽  
Warfarin Therapy ◽  
Fresh Frozen Plasma ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
Therapeutic Window ◽  
Laboratory Findings ◽  
Medical Disorders ◽  
Fresh Frozen

AbstractIntroduction. Warfarin is one of the most frequently used anticoagulant agents in the clinic. The most important adverse effect of warfarin is hemorrhage of vital organs, such as lung and brain. Diffuse Alveolar Hemorrhage (DAH) is a rare clinical condition which occurs due to variety of medical disorders. Although it’s rarely reported, DAH can be a result of coagulopathy prompted by warfarin therapy. In this study we present a case of DAH, caused by warfarin toxicity which referred to the hospital with non-specific respiratory symptoms.Case presentation. A 41-year-old female patient referred to the hospital complaining of shortness of breath, cough and dizziness. She had been taking warfarin due to mitral valve replacement for the past 10 years. Her recent symptoms began shortly after taking amoxicillin, a few days before admission. Early clinical examination and paraclinical studies reveal DAH as the cause of respiratory symptoms. The patient was then intubated and received fresh frozen plasma, packed cells and oral vitamin K. Laboratory findings apart from increased INR, PT, ESR and CRP were all within normal range. After the initiation of treatment patient’s INR decreased and her clinical condition improved. Follow-up CT-Scan and bronchoscopy also confirmed resolving DAH.Conclusions. The usage of warfarin in anticoagulation should be closely monitored due to its narrow therapeutic window and other factors, including its interaction with other medications such as antibiotics. Warfarin toxicity can lead to DAH, a life-threatening condition which can be presented with non-specific symptoms and deteriorate patient’s clinical condition in a short time. Therefore, it is of utmost importance to watch closely for primary symptoms of such rare incident in patients under warfarin therapy and initiate treatment as soon as possible, to prevent mortality.

scholarly journals Diffuse Alveolar Hemorrhage Caused by Warfarin after Rifampicin Discontinuation

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Takashige Kiyota ◽  
Seiji Shiota ◽  
Ryosuke Hamanaka ◽  
Daisuke Tsutsumi ◽  
Takeshi Takakura ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Prothrombin Time ◽  
Persistent Infection ◽  
Warfarin Therapy ◽  
Anticoagulant Activity ◽  
International Normalized Ratio ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
High Resolution Computed Tomography

An 83-year-old man under warfarin therapy presented for assessment of prolonged prothrombin time and cough. High-resolution computed tomography findings of the chest showed diffuse alveolar hemorrhage. His international normalized ratio (INR) was 11.89. He had been treated with rifampicin for a persistent infection, but this had been discontinued about two months before admission. Rifampicin suppresses the anticoagulant activity of warfarin, which can lead to a need for increased doses of warfarin to achieve and maintain a therapeutic INR. More frequent INR monitoring is needed even after discontinuing rifampicin.

scholarly journals A Case of Diffuse Alveolar Hemorrhage Associated with Tegafur plus Uracil and Warfarin Therapy

2011 ◽  
Vol 4 ◽  
pp. CCRep.S8522 ◽  
Author(s):  
Masayuki Itoh ◽  
Shuji Oh-ishi ◽  
Kenji Nemoto ◽  
Seitaro Senba ◽  
Hideki Adachi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Computed Tomography ◽  
Lung Cancer ◽  
Bronchoalveolar Lavage Fluid ◽  
Warfarin Therapy ◽  
Lavage Fluid ◽  
International Normalized Ratio ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
Sequential Samples

A 72-year-old man who received warfarin for myocardial infarction (prothrombin time-international normalized ratio [PT-INR] controlled between 2.2 and 2.5) for 2 years. He developed lung cancer, underwent surgery, and received tegafur plus uracil (UFT) after 1 month. After 2 months, he was admitted for hemoptysis and dyspnea. Chest radiography and computed tomography showed bilateral alveolar infiltration (PT-INR, 8.9). Bronchoalveolar lavage fluid (BALF) disclosed hemorrhagic features in sequential samples. And he was diagnosed with diffuse alveolar hemorrhage (DAH). A known interaction exists between fluoropyrimidines and warfarin. So, they were discontinued, and vitamin K was intravenously administered. One day later, the PT-INR returned to 1.14. The symptoms improved and, alveolar infiltration resolved after 2 weeks. Alveolar hemorrhage may be due to an interaction between UFT and warfarin. When fluoropyrimidines and warfarin are prescribed simultaneously, we recommend that PT-INR should be closely monitored.

scholarly journals Diffuse Alveolar Hemorrhage Associated with Warfarin Therapy

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Bülent Kaya ◽  
Ibrahim Yildiz ◽  
Reshat Mehmet Baha ◽  
Neslihan Ebru Eryaşar Zeytun ◽  
Azize Yetisgen
Keyword(s):  
Case Report ◽  
Warfarin Therapy ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
Life Threatening ◽  
Life Threatening Complication

Diffuse alveolar hemorrhage (DAH) is a life-threatening clinical pathologic syndrome caused by a variety of diseases. We report a case of DAH related to therapy of warfarin use. In this case report, we present the diffuse alveolar hemorrhage case as a rare and life-threatening complication of warfarin.

Diffuse Alveolar Hemorrhage After Orotracheal Extubation Probably Induced by Sevoflurane Inhalation

2021 ◽  
Vol 57 (8) ◽  
pp. 547-548
Author(s):  
Mauro Carvalho Mendonça ◽  
João Bettencourt Abreu ◽  
Karina Gama
Keyword(s):  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage

scholarly journals Negative-pressure-related diffuse alveolar hemorrhage after monitored anesthesia care for vertebroplasty: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yumin Jo ◽  
Jagyung Hwang ◽  
Jieun Lee ◽  
Hansol Kang ◽  
Boohwi Hong
Keyword(s):  
Case Report ◽  
Airway Obstruction ◽  
Negative Pressure ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
Unknown Etiology ◽  
Anesthesia Care ◽  
Monitored Anesthesia Care ◽  
X Ray ◽  
Chest X Ray

Abstract Background Diffuse alveolar hemorrhage (DAH) is a rare, life-threatening condition that can present as a spectrum of nonspecific symptoms, ranging from cough, dyspnea, and hemoptysis to severe hypoxemic respiratory failure. Perioperative DAH is frequently caused by negative pressure pulmonary edema resulting from acute airway obstruction, such as laryngospasm, although hemorrhage itself is rare. Case presentation This case report describes an unexpected hemoptysis following monitored anesthesia care for vertebroplasty. A 68-year-old Asian woman, with a compression fracture of the third lumbar vertebra was admitted for vertebroplasty. There were no noticeable events during the procedure. After the procedure, the patient was transferred to the postanesthesia care unit (PACU), at which sudden hemoptysis occurred. The suspected airway obstruction may have developed during transfer or immediate arrive in PACU. In postoperative chest x-ray, newly formed perihilar consolidation observed in both lung fields. The patients was transferred to a tertiary medical institution for further evaluation. She diagnosed with DAH for hemoptysis, new pulmonary infiltrates on chest x-ray and anemia. The patient received supportive care and discharged without further events. Conclusions Short duration of airway obstruction may cause DAH, it should be considered in the differential diagnosis of postoperative hemoptysis of unknown etiology.

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