warfarin and Peripheral-Nervous-System-Diseases

Topics: Administration, Oral; Atrial Fibrillation; Dose-Response Relationship, Drug; Embolism; Factor Xa Inhibitors; Humans; Multicenter Studies as Topic; Peripheral Nervous System Diseases; Randomized Controlled Trials as Topic; Rivaroxaban; Stroke; Vitamin K; Warfarin

Adverse drug reactions (ADRs) rank as one of the top ten leading causes of death and illness in the developed world. In cancer therapy, more patients are surviving cancer than ever before, but 40% of cancer survivors suffer life-threatening or permanently disabling severe ADRs and are left with long-term sequelae. ADRs are often more frequent and more severe in children, and the consequences for children who experience a severe ADR can be catastrophic. Pharmacogenomics has the potential to improve the safety of these drugs. This review highlights severe ADRs that can occur in cancer therapy that are more frequent and more severe in children, and the pharmacogenomics research that aims to understand, predict, and ultimately prevent these severe reactions.

Topics: Anthracyclines; Antineoplastic Agents; Child; Cisplatin; Humans; Methotrexate; Neoplasms; Peripheral Nervous System Diseases; Pharmacogenetics; Vincristine; Warfarin

We report a case of a 60-year-old man who was referred to a palliative care clinic with monoclonal gammopathy of undetermined significance (MGUS)-associated neuropathy, responding to a therapeutic trial of warfarin. Electromyography showed distal symmetric sensory axonal neuropathy. The patient reported having had improvement of his neuropathic symptoms while taking warfarin postoperatively for thromboprophylaxis 1 year prior, and recurrence of his symptoms after the warfarin was discontinued. The patient was rechallenged with a trial of warfarin, targeting an international normalised ratio of 1.5-2.0. His pain scores decreased from 5/10 to 3/10 at 1 month and symptom improvement was maintained through 24 months of follow-up. Warfarin had a remarkable impact on our patient's symptoms and quality of life. The mechanisms mediating the symptomatic benefit with warfarin are unclear; however, a placebo effect is unlikely. Further studies may help guide the use of warfarin for MGUS-associated neuropathy.

Topics: Anticoagulants; Humans; Male; Middle Aged; Monoclonal Gammopathy of Undetermined Significance; Peripheral Nervous System Diseases; Treatment Outcome; Warfarin

Topics: Adverse Drug Reaction Reporting Systems; Aged; Anemia, Hemolytic, Autoimmune; Anti-Infective Agents; Anticoagulants; Benzodiazepines; Caffeine; Canada; Ceftriaxone; Central Nervous System Stimulants; Child; Drug Interactions; Female; Humans; Ketolides; Middle Aged; Olanzapine; Peripheral Nervous System Diseases; Phytotherapy; Pulmonary Embolism; Rhabdomyolysis; Selective Serotonin Reuptake Inhibitors; Warfarin; Weight Loss

A 34-year-old woman was admitted to our emergency room with a high fever, abdominal pain, dyspnea and confusion. High fever and abdominal pain had first occured after a cystocele operation 5 months earlier. Later, congestive heart failure with mural thrombus formation, peripheral polyneuropathy and ischemic cerebrovascular accident were identified in clinical follow-ups, and multiple arterial and venous thromboses were seen on cranial and abdominal magnetic resonance imaging angiography. The patient's symptoms improved with anticoagulant treatment. Antiphospholipid syndrome with elevated serum anticardiolipin IgG levels was diagnosed, and ischemic peripheral polyneuropathy with axonal degeneration was determined by sural nerve biopsy. In antiphospholipid syndrome, elevated anticardiolipin antibodies appear to be the most common acquired blood protein defect causing thrombosis. Disseminated vascular thrombosis in catastrophic antiphospholipid syndrome can result in multiorgan failure with increased morbidity and mortality. It rarely occurs secondary to various infections as in the case of our patient, who suffered postoperative intraabdominal infection. It is important to note that peripheral nervous system involvement is rare in antiphospholipid syndrome.

Topics: Acute Disease; Adult; Anticoagulants; Antiphospholipid Syndrome; Female; Humans; Peripheral Nervous System Diseases; Postoperative Complications; Sural Nerve; Surgical Wound Infection; Urinary Bladder Diseases; Warfarin

Warfarin is frequently used as an anticoagulant. The most common and serious complication is bleeding. We present a 43-year-old warfarinized patient who was admitted with unilateral groin pain and a neurological deficit of the lumbar nerve root L1-4. A CT scan showed a haematoma in and behind the ilio-psoas muscle extending to below the inguinal ligament, due to a warfarin induced coagulation deficit (INR 7.0) which was reversed on admission with vitamin K. There is no conclusive evidence in the literature supporting either conservative or surgical treatment modalities. Our patient was successfully treated conservatively.

Topics: Acute Disease; Adult; Anticoagulants; Femoral Nerve; Hematoma; Humans; Inguinal Canal; Lumbar Vertebrae; Male; Nerve Compression Syndromes; Pain; Pain Management; Peripheral Nervous System Diseases; Psoas Muscles; Radiography; Ultrasonography; Warfarin

Topics: Femoral Nerve; Hematoma; Humans; Male; Middle Aged; Peripheral Nervous System Diseases; Retroperitoneal Space; Warfarin

Topics: Acute Disease; Administration, Oral; Anticoagulants; Femoral Nerve; Humans; Male; Middle Aged; Peripheral Nervous System Diseases; Prothrombin Time; Warfarin

Topics: Femoral Nerve; Hematoma; Hemorrhagic Disorders; Humans; Iatrogenic Disease; Male; Manipulation, Orthopedic; Middle Aged; Peripheral Nervous System Diseases; Warfarin

Topics: Acute Disease; Administration, Oral; Femoral Nerve; Humans; Male; Middle Aged; Motor Neurons; Neural Conduction; Peripheral Nervous System Diseases; Time Factors; Warfarin

Topics: Adult; Age Factors; Cholecystitis; Chromium Alloys; Follow-Up Studies; Gastrointestinal Hemorrhage; Hepatitis; Hip; Hip Dislocation; Hip Joint; Humans; Joint Prosthesis; Middle Aged; Molecular Weight; Peripheral Nervous System Diseases; Polyethylenes; Postoperative Complications; Prosthesis Design; Surgical Wound Infection; Thromboembolism; Urinary Tract Infections; Warfarin

Topics: Adult; Aged; Anticoagulants; Female; Femoral Nerve; Heparin; Humans; Male; Middle Aged; Peripheral Nervous System Diseases; Phenindione; Thrombophlebitis; Warfarin

Topics: Adult; Anticoagulants; Dyspnea; Female; Hemorrhage; Heparin; Humans; Male; Middle Aged; Muscular Diseases; Peripheral Nervous System Diseases; Pregnancy; Warfarin; Wounds and Injuries

Topics: Femoral Nerve; Humans; Hypoprothrombinemias; Male; Middle Aged; Pain; Peripheral Nervous System Diseases; Warfarin