warfarin and Leiomyoma

Cerebral venous sinus thrombosis (CVST) is a rare, high-risk, and easily misdiagnosed disease. Currently, there are case reports of hem coagulase-induced thrombotic events, but no reports of CVST being associated with hem coagulase.. A 35-years-old woman presented to the outpatient clinic with a severe headache and sudden memory loss with intravenous hem coagulase for postoperative bleeding after uterine fibroids surgery. Abnormal neurological signs included slowed reactions, poor memory, and decreased numeracy. Magnetic resonance imaging and computed tomography scan showed multiple cerebral infarcts, and the infarct area was non-arterial. Brain magnetic resonance venography showed obstruction of the left sigmoid sinus. High-resolution magnetic resonance imaging of the left sigmoid sinus showed abnormally high signal. The patient was treated with a subcutaneous Low-Molecular-Weight Heparin Sodium injection 0.4 ml, twice a day (7 days), and oral Warfarin Sodium 3 mg, once a day, while monitoring the international normalized ratio, adjust the warfarin sodium dosage according to the international normalized ratio level. One month later, the patient had no neurological symptoms and her cognitive function returned to normal.. hem coagulase may be a contributing factor to CVST in patients undergoing uterine fibroids surgery and should be administered intravenously with caution.

Topics: Adult; Coagulase; Female; Humans; Leiomyoma; Magnetic Resonance Imaging; Sinus Thrombosis, Intracranial; Warfarin

Non-puerperal uterine inversion and cranial nerve palsies in patients with sigmoid sinus thrombosis are both extremely rare. We report a case of a patient who presented with both simultaneously. The symptoms of sigmoid sinus thrombosis resolved with subcutaneous enoxaparin, and an abdominal dissection with removal of the uterus vaginally resulted in a successful outcome for the patient.

Topics: Adult; Anticoagulants; Cranial Sinuses; Drug Administration Schedule; Enoxaparin; Facial Paralysis; Female; Headache; Humans; Hysterectomy; Leiomyoma; Sinus Thrombosis, Intracranial; Treatment Outcome; Uterine Inversion; Uterine Neoplasms; Warfarin

Topics: Adult; Anticoagulants; Drug Combinations; Factor IX; Factor VII; Factor X; Female; Humans; Leiomyoma; Prothrombin; Uterine Hemorrhage; Uterine Neoplasms; Warfarin

Hereditary antithrombin (AT) deficiency is associated with a significant risk of venous thromboembolism. Patients with this disorder frequently require long-term anticoagulation. Discontinuation of anticoagulation for childbirth or surgery may carry a substantial thrombotic risk. For this reason, replacement with AT concentrate has been used when anticoagulation is interrupted. A new recombinant human AT concentrate, produced using transgenic technology, has recently been developed.. Human recombinant AT (rhAT) was provided by GTC Biotherapeutics, Inc. on a compassionate-use basis for five patients with hereditary AT deficiency who underwent six surgical procedures. Patients were treated perioperatively. Dosing was determined individually by the investigators with a goal of maintaining an AT activity of 80 to 150 percent.. There was no clinical evidence of thrombosis or bleeding. Four of the five patients had postoperative duplex ultrasound studies of the lower extremities, which showed no evidence of acute thrombosis. Four patients were tested for antirecombinant rhAT antibodies postoperatively and were negative.. These case reports indicate that rhAT can provide effective support for AT-deficient patients who undergo surgery. Further study of this product is needed to define optimal dosing and further assess clinical response.

Topics: Adult; Aged; Anticoagulants; Antithrombins; Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Cesarean Section; Coronary Artery Bypass; Coronary Disease; Enoxaparin; Factor V; Female; Heparin; Humans; Hysterectomy; Leiomyoma; Male; Middle Aged; Postoperative Complications; Pregnancy; Recombinant Proteins; Splenectomy; Sterilization, Tubal; Surgical Procedures, Operative; Uterine Neoplasms; Venous Thrombosis; Warfarin