Waness Abdelkarim, Aldabbagh Tarek, Harakati Mohammed
King Abdulaziz Medical City for National Guards, Internal Medicine - Code 1443, PO Box 22490, Riyadh 11426, Saudi Arabia.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.08.2008.0757. Epub 2009 Mar 17.
Alveolar haemorrhage is a rare and serious medical emergency with many causes. Diffuse alveolar haemorrhage due to warfarin therapy has been rarely reported in the literature. In this paper, we describe the case of 62-year-old woman with a history of chronic atrial fibrillation treated with warfarin, who was admitted to our institution with haemoptysis and dyspnoea. Alveolar haemorrhage was suspected clinically and subsequently confirmed by bronchoscopy. The patient required aggressive treatment with fresh frozen plasma, vitamin K and mechanical ventilation with a successful outcome. We emphasise the need for early diagnosis and fast therapeutic intervention, especially with over-anticoagulation (INR >9), in patients with this rare and potentially lethal condition.
肺泡出血是一种罕见且严重的医疗急症，病因众多。文献中关于华法林治疗导致弥漫性肺泡出血的报道很少。在本文中，我们描述了一名62岁有慢性房颤病史且接受华法林治疗的女性病例，她因咯血和呼吸困难入住我院。临床怀疑为肺泡出血，随后经支气管镜检查得以确诊。患者需要输注新鲜冰冻血浆、维生素K并进行机械通气等积极治疗，最终获得成功。我们强调对于这种罕见且可能致命的疾病患者，尤其是存在抗凝过度（国际标准化比值>9）的情况，需要早期诊断并迅速进行治疗干预。
