Klenner Anne F, Friesecke Sigrun, Schäper Christoph, Ewert Ralf, Gläser Sven
Department of Hematology/Oncology, Ernst-Moritz-Arndt University Greifswald, Germany.
Blood Coagul Fibrinolysis. 2008 Dec;19(8):813-5. doi: 10.1097/MBC.0b013e32830f1bc2.
An 84-year-old woman was admitted to the emergency room with hemoptysis consisting of relevant amounts of fresh blood. She was treated with phenprocoumon for 11 years following mechanical aortic valve replacement without any complication. Laboratory results revealed phenprocoumon over dosage with international normalized ratio over 6. Chest radiograph showed diffuse alveolar infiltrates conformable to diffuse alveolar hemorrhage. Besides the pulmonary complication no other bleeding occurred. She needed noninvasive ventilatory support for 24 h to cope with the symptoms of an acute respiratory failure. After substitution of vitamin K dependent blood clot factors resulting in a normalized coagulation hemoptysis which persisted for another 3 days followed by a slow recovery. Other causes of diffuse alveolar hemorrhage were excluded in our patient. This case report presents a rare case with diffuse alveolar hemorrhage as the leading and sole symptom due to phenprocoumon overdose.
一名84岁女性因咯血（咯出大量新鲜血液）被送入急诊室。她在接受机械主动脉瓣置换术后接受苯丙香豆素治疗11年，无任何并发症。实验室检查结果显示苯丙香豆素过量，国际标准化比值超过6。胸部X线片显示弥漫性肺泡浸润，符合弥漫性肺泡出血。除肺部并发症外，未发生其他出血情况。她需要无创通气支持24小时以应对急性呼吸衰竭症状。在补充维生素K依赖的凝血因子使凝血功能恢复正常后，咯血持续了3天，随后逐渐恢复。我们的患者排除了弥漫性肺泡出血的其他原因。本病例报告展示了一例罕见病例，因苯丙香豆素过量导致弥漫性肺泡出血成为主要且唯一的症状。
