phenprocoumon and Hematuria

A 61-year old woman with atrial fibrillation developed macrohaematuria during anticoagulant treatment with a direct oral factor Xa inhibitor for stroke prevention. Abnormal results of coagulation assays were first interpreted as an effect of the anticoagulant. However, upon further testing diagnosis of vitamin K deficiency was established. After vitamin K supplementation, coagulation tests normalized and macrohaematuria disappeared. Treatment with broad spectrum antibiotics for urinary tract infection was finally established as a rare cause for vitamin K deficiency in the patient.

Topics: Administration, Oral; Anti-Bacterial Agents; Anticoagulants; False Positive Reactions; Female; Hematuria; Humans; Middle Aged; Phenprocoumon; Treatment Outcome; Vitamin K; Vitamin K Deficiency

We report the case of a 71-year-old male patient who presented at the emergency room with episodes of epistaxis and jaundice. The patient was on therapy with phenprocoumon, atorvastatin and perindopril. Findings on admission included prominent elevation of transaminases and bilirubin and a high INR due to impaired liver function and oral anticoagulation. After exclusion of other causes like viral or autoimmune hepatitis and after having obtained a liver biopsy, a diagnosis of drug induced liver damage (DILI) was made. Epidemiology, pathophysiology and clinical signs of DILI are discussed with a special focus on coumarines, statins and ACE-inhibitors.

Topics: Administration, Oral; Aged; Angiotensin-Converting Enzyme Inhibitors; Anticoagulants; Atorvastatin; Biopsy; Chemical and Drug Induced Liver Injury; Drug Interactions; Drug Therapy, Combination; Hematuria; Heptanoic Acids; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Liver; Liver Function Tests; Male; Perindopril; Phenprocoumon; Pyrroles; Vitamin K

Topics: Aged; Anticoagulants; Drug Overdose; Hematoma; Hematuria; Humans; Male; Medication Errors; Phenprocoumon; Retroperitoneal Space; Time Factors

Topics: 4-Hydroxycoumarins; Female; Hematuria; Histrionic Personality Disorder; Humans; Middle Aged; Munchausen Syndrome; Phenprocoumon; Self Medication; Substance-Related Disorders

Topics: 4-Hydroxycoumarins; Female; Hematuria; Humans; Middle Aged; Phenprocoumon

Topics: 4-Hydroxycoumarins; Hematuria; Humans; Phenprocoumon

Four patients with different forms of glomerulonephritis were treated with the anticoagulant heparin (Liquemin) or phenprocoumon (Marcumar). Following the results in these cases and the experiences of other research groups, which have been published in the last few years, we have tried to lay down a scheme for treatment with anticoagulants in glomerulonephritis. Such a treatment is recommended in peracute or rapid progressing glomerulonephritis, in forms of the disease of which is known that they have a poor prognosis, and in situations in which the risk of simultaneous thromboembolic complications as a result of a nephrotic syndrome represents a further argument for the use of anticoagulants.

Topics: 4-Hydroxycoumarins; Acute Kidney Injury; Adult; Creatinine; Female; Glomerulonephritis; Hematuria; Heparin; Humans; Male; Nephrotic Syndrome; Phenprocoumon; Prognosis; Proteinuria