Binymin Khalid A, Nasher Magda, Patel Dipti
Liverpool University, Medical School, England, UK.
Southport and Ormskirk NHS Trust, Southport District General Hospital, Kew, UK.
Int Med Case Rep J. 2014 Sep 9;7:123-5. doi: 10.2147/IMCRJ.S62100. eCollection 2014.
We are presenting a 72-year-old female who was admitted to hospital with deep vein thrombosis (DVT). She was known to have atrial fibrillation and was initiated on warfarin for stroke prophylaxis 3 days earlier. She was given warfarin therapy without low molecular weight heparin cover as per "slow-start regimen" protocol. The warfarin dose was increased after 3 days to achieve rapid anticoagulation, resulting in DVT in the left leg. We propose that the higher unopposed warfarin dose utilized in this case resulted in DVT. Warfarin loading doses may paradoxically result in a hypercoagulable state and potential clot formation because of significant reductions in protein C and protein S levels.
我们正在介绍一位72岁的女性患者，她因深静脉血栓形成（DVT）入院。已知她患有心房颤动，3天前开始服用华法林以预防中风。根据“缓慢启动方案”，她接受了华法林治疗，但未使用低分子量肝素覆盖。3天后增加了华法林剂量以实现快速抗凝，结果导致左腿出现深静脉血栓形成。我们认为，本病例中使用的较高剂量的未对抗华法林导致了深静脉血栓形成。由于蛋白C和蛋白S水平显著降低，华法林负荷剂量可能反常地导致高凝状态和潜在的血栓形成。
