warfarin and Uterine-Neoplasms

Topics: Animals; Anticoagulants; Female; Fibrinolysin; Fibrinolysis; Fibrinolytic Agents; Heparin; Humans; Immunosuppression Therapy; Lung Neoplasms; Neoplasm Metastasis; Neoplasms; Neoplasms, Experimental; Peptide Hydrolases; Uterine Neoplasms; 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

A 35-year-old woman, who underwent the removal of her uterus as a result of treatment for cancer of the cervix, developed weakness in the distal lower limbs after 8 months of subsequent radiation therapy. Although she could not walk because of distal dominant weakness and atrophy in the legs, no sensory disturbances were observed. An MRI scan showed gadolinium enhancement of the anterior portion of the lumbosacral roots in the cauda equina, which corresponded to her neurological symptoms. The administration of corticosteroid and warfarin dramatically alleviated her neurological symptoms, and a follow-up MRI scan one month later demonstrated a marked diminution of the gadolinium enhancement. There were only seven reports describing the abnormalities of the MRI findings, all of which noted the gadolinium enhancement of the anterior portion of the lumbosacral roots. Together with the findings in other reports, the enhancement abnormalities seem to be characteristic of post-irradiation lumbosacral radiculopathy.

Topics: Adult; Drug Therapy, Combination; Female; Gadolinium DTPA; Humans; Lumbosacral Region; Magnetic Resonance Imaging; Prednisolone; Radiation Injuries; Radiculopathy; Radiotherapy; 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

Topics: Adrenal Gland Diseases; Adrenocorticotropic Hormone; Combined Modality Therapy; Female; Hemorrhage; Humans; Hydrocortisone; Hypotension; Leiomyosarcoma; Middle Aged; Thrombophlebitis; Tomography, X-Ray Computed; Uterine Neoplasms; Vena Cava Filters; Warfarin

Aminoglutethimide (AG) has recently been introduced for endocrine therapy in patients with advanced breast and endometrial cancer. In this study two patients being treated with both AG and the anticoagulant agent warfarin are described. An important drug interaction was observed, resulting in a decrease in the anticoagulant effect of warfarin. This was shown by means of thrombotest measurements and pharmacokinetic evaluation of warfarin. A 3- to 5-fold increase in warfarin clearance was found. This interaction is probably due to an AG-promoted induction of hepatic microsomal enzymes accelerating warfarin metabolism.

Topics: Aged; Aminoglutethimide; Chromatography, High Pressure Liquid; Drug Interactions; Female; Humans; Kinetics; Thrombophlebitis; Uterine Neoplasms; Warfarin