acenocoumarol and Carcinoma--Non-Small-Cell-Lung

Acquired haemophilia A is a rare disorder caused by spontaneous formation of auto-antibodies (inhibitors) against coagulation factor VIII. This can lead tolife-threatening haemorrhages. Six to twenty-two percent of patients with acquired haemophilia have an underlying malignancy. We describe a 69-year-old woman with metastatic breast cancer and non-small cell lung carcinoma who presented at the emergency room with spontaneous bruising, and who was using a vitamin K antagonist. She had a prolonged activated partial thromboplastin time (aPTT) due to a coagulation factor VIII deficiency caused by factor VIII antibodies. She was treated with prednisone and cyclophosphamide.

Topics: Acenocoumarol; Aged; Anticoagulants; Breast Neoplasms; Carcinoma, Non-Small-Cell Lung; Female; Hemophilia A; Humans; Lung Neoplasms

Drug interactions can cause many clinical problems, particularly when the drugs are administered in combination with anticancer agents.. A patient required two hospitalizations due to risk of bleeding with altered INR probably due to an interaction between gefitinib and acenocoumarol, which resulted in the potentiation of the effect of the latter and acenocoumarol dose adjustment was needed. A causality assessment between the drug-drug interaction and the augmented INR was conducted according to Naranjo algorithm and was classified as a definite adverse drug reaction.. Patient's management recommended is to closely monitor for changes in the effects of coumarin derivatives, if administered concomitantly with antineoplasic agents.

Topics: Acenocoumarol; Adenocarcinoma; Aged; Anticoagulants; Antineoplastic Agents; Atrial Fibrillation; Carcinoma, Non-Small-Cell Lung; Drug Interactions; Gefitinib; Heart Failure; Humans; International Normalized Ratio; Lung Neoplasms; Male; Protein Kinase Inhibitors; Quinazolines

We report a case of a 53-year-old male who presented with thoracodynia three months after right pneumonectomy. Chest CT-scan demonstrated thrombus at the pulmonary artery stump without any other abnormal finding. He was treated successfully with acenocoumarol. We present this case analyzing the possible causes and discussing the treatment.

Topics: Acenocoumarol; Anticoagulants; Carcinoma, Non-Small-Cell Lung; Humans; Ligation; Lung Neoplasms; Male; Middle Aged; Pneumonectomy; Pulmonary Artery; Pulmonary Embolism; Thrombosis; Tomography, X-Ray Computed