acenocoumarol and Hemoptysis

Topics: Acenocoumarol; Aged; Anticoagulants; Atrial Fibrillation; Comorbidity; Dose-Response Relationship, Drug; Drug Substitution; Factor Xa Inhibitors; Hemoptysis; Humans; International Normalized Ratio; Lung; Male; Pyrazoles; Pyridones; Thrombophilia; Tomography, X-Ray Computed

Intra-alveolar bleeding is a rare and severe medical emergency due to numerous causes. We report the clinical case of a patient who could contribute to extend the literature on this subject. The study included a 62-year old man, with a history of a trial fibrillation, under anti-vitamins K antagonist admitted with dyspnoea of sudden onset associated with haemoptysis and practising self-medication using non-steroidal anti-inflammatory drugs. X-rays and chest scan showed diffuse bilateral alveolar opacities. Haemostatic screening tests on admission showed non-coagulable INR. The diagnosis of intra-alveolar bleeding was clinically and radiologically suspected and then confirmed by bronchial endoscopy with broncho-alveolar lavage (BAL) which detected uniformly hemorrhagic liquid. Previous studies of similar complications occurring after anti-vitamins K antagonists assumption are rare. In conclusion, it seems very important to emphasize the interest of strict and optimal clinico-biological monitoring of patients treated in anti-vitamins K antagonists to avoid an overdose which could contribute to a life-threatening severe haemorrhagic event.

Topics: Acenocoumarol; Anticoagulants; Dyspnea; Hemoptysis; Hemorrhage; Humans; Male; Middle Aged; Pulmonary Alveoli; Vitamin K

Behçet's disease is a vasculitis affecting both arteries and veins. Cardiac involvement is less well known. The association of an aneurysm of the pulmonary artery and intracardiac thrombosis is rare, and a therapeutic challenge. We report the case of a 26-year-old patient hospitalized for moderately abundant hemoptysis and New York Heart Association (NYHA) class III dyspnea, which illustrates the difficulty encountered when using anticoagulants in this complex situation.

Topics: Acenocoumarol; Adult; Aneurysm; Anticoagulants; Behcet Syndrome; Cyclophosphamide; Dyspnea; Heart Atria; Heart Diseases; Hemoptysis; Heparin; Humans; Male; Pulmonary Artery; Pulmonary Embolism; Recurrence; Thrombosis; Ultrasonography; Weight Loss

Topics: Acenocoumarol; Aged; Amiodarone; Anemia; Anti-Arrhythmia Agents; Anticoagulants; Dyspnea; Hemoptysis; Hemorrhage; Humans; Lung Diseases; Male

Bleeding into the lung parenchyma is a rare phenomenon that usually occurs as a result of chest trauma, other causes are anticoagulant therapy, and infections. The following case presents a patient admitted to the hospital due to haemoptysis, which was a symptom of bleeding into the emphysematosus bulla caused by anticoagulation therapy. The decisive diagnostic examination was chest magnetic resonance. This imaging method allows the precise differentiation of tissues. Using modern imaging techniques can often dispense with invasive diagnostic methods.

Topics: Acenocoumarol; Anticoagulants; Blister; Diagnosis, Differential; Emphysema; Hemoptysis; Hemorrhage; Humans; Lung Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Pulmonary Disease, Chronic Obstructive; Pulmonary Embolism; Tuberculosis, Pulmonary

A case report of young woman diagnosed as having microscopic polyangiitis (MPO) presenting with diffuse alveolar hemorrhage (DAH). DAH is a rare, but life-threatening disorder. The patients presented with dyspnea, cough, hemoptysis (not constant). The radiographic features are very characteristic and reveal the signs of diffuse, bilateral alveolar filling in chest HRCT especially in middle and lower zones. Anaemia with iron deficiency and hypoxic respiratory failure. Elevation of diffuse capacity (above 30% of predicted) is often recognized as a result of presence of blood in the alveoli. Broncho-alveolar lavage reveal haemosiderin laden macrophages. It may occurs most frequently as a secondary condition due to microscopic polyangiitis (MPA), Wegener's granulomatosis (WG), Goodpasture syndrome. Among the many conditions it can accompany connective tissue disorders, antiphospholipid antibody syndrome, some medicines or toxic exposures.

Topics: Acenocoumarol; Anticoagulants; Diagnosis, Differential; Dyspnea; Female; Hemoptysis; Hemorrhage; Humans; Lung Diseases, Interstitial; Microscopic Polyangiitis; Venous Thrombosis

In this study we presented the case of 55 years old man who was admitted to the Dept. of Lung Diseases and Tuberculosis in Zabrze with haemoptysis, dyspnoea, fever and lung infiltration. Initially the neoplastic disease was diagnosed. From the information gathered from the patient's family it was stated that the patient has been taking acenocoumarol for a considerably long time without any professional supervision. In this study we emphasize the importance of motivating and informing patients about the purposefulness of control examinations while using this kind of drugs.

Topics: Acenocoumarol; Anticoagulants; Autopsy; Dyspnea; Fatal Outcome; Fever; Hemoptysis; Humans; Lung Diseases; Lung Neoplasms; Male; Middle Aged