[Serious bleeding complications caused by warfarin with international normalized ratio 2.1].

Abstract

The risk of bleeding due to anticoagulation therapy with warfarin rises exponentially, when the international normalized ratio (INR) exceeds 4.5. We present a 52-year-old male admitted to the hospital with severe bleeding in the lower limbs caused by warfarin. Laboratory tests showed therapeutic INR (2.1), however the activated partial tromboplastin time was unusually prolonged (135 sec.) and a severe, reversible reduction in factor IX was detected. These findings were suggestive of a mutation in the factor IX propeptide, but thrombocytopathy induced by selective serotonin re-uptake inhibitors could have worsened the bleeding.

• Authors: Casper Kierulf-Lassen, Anne-Mette Hvas, Birgitte Klindt Poulsen
• Journal: Ugeskrift for laeger (Ugeskr Laeger) Vol. 177 Issue 2A Pg. 52-3 (Jan 26 2015) ISSN: 1603-6824 [Electronic] Denmark
• Vernacular Title: Alvorlige blødningskomplikationer udløst af warfarinbehandling med international normalized ratio 2,1.
• PMID: 25612965 (Publication Type: Case Reports)

Chemical References

• Anticoagulants
• Warfarin

Topics

• Anticoagulants (adverse effects)
• Hemophilia B (diagnosis)
• Hemorrhage (chemically induced)
• Humans
• International Normalized Ratio
• Lower Extremity
• Male
• Middle Aged
• Warfarin (adverse effects)