Erdogan Dogan, Kocaman Orhan, Oflaz Huseyin, Goren Taner
Istanbul Medical Faculty, Istanbul University, Capa, Istanbul, Turkey.
Int J Cardiovasc Imaging. 2004 Apr;20(2):155-9. doi: 10.1023/b:caim.0000014101.06445.66.
A 75-year-old man was admitted to our clinic with the complaints of palpitation, fever, severe dyspnea, dizziness and bloody sputum associated with coughing. Chest radiographs revealed that the lungs were bilaterally infiltrated. A high resolution computed tomographic study of the thorax disclosed diffuse alveolar hemorrhage, of which presence was proved by histopathological study of bronchoalveolar lavage material. The hemorrhage occured at 8th day of 5 mg daily warfarin therapy, which was given for frequent atrial fibrillation attacks was controlled by fresh frozen plasma and vitamin K. Alveolar hemorrhage is difficult to diagnose and has high mortality if the treatment was not started as soon as possible. This is the first report of alveolar hemorrhage caused by 5 mg daily warfarin therapy. We propose that the patient's age, nutritional status, used drugs should be taken into consideration for true management of patients with atrial fibrillation.
一名75岁男性因心悸、发热、严重呼吸困难、头晕及咳嗽伴咯血痰而入住我院。胸部X线片显示双肺浸润。胸部高分辨率计算机断层扫描研究发现弥漫性肺泡出血，支气管肺泡灌洗材料的组织病理学研究证实了其存在。出血发生在每日服用5毫克华法林治疗的第8天，该治疗用于频繁发作的心房颤动，通过新鲜冷冻血浆和维生素K得到控制。肺泡出血难以诊断，如果不尽快开始治疗，死亡率很高。这是关于每日5毫克华法林治疗引起肺泡出血的首例报告。我们建议，对于心房颤动患者的真正管理，应考虑患者的年龄、营养状况和所用药物。
