Orhun Nagihan, Ekin Utku, Sanchez Jessimar, Azzam Moh'd Hazem, Manickam Rajapriya
Department of Internal Medicine, St. Joseph's University Medical Center, Paterson, USA.
Department of Pulmonary and Critical Care Medicine, St. Joseph's University Medical Center, Paterson, USA.
Eur J Case Rep Intern Med. 2024 Feb 12;11(3):004299. doi: 10.12890/2024_004299. eCollection 2024.
Spontaneous bleeding into the upper airways is a rare and potentially life-threatening complication of chronic anticoagulation. There are scarce cases in the literature demonstrating upper airway haematomas secondary to warfarin use, which is the predominant anticoagulant used by clinicians despite having a complex pharmacokinetic and pharmacodynamic profile. We report a compelling case featuring warfarin-induced sublingual haematoma, managed conservatively through the reversal of anticoagulation using fresh frozen plasma complemented by vigilant monitoring within the Intensive Care Unit (ICU).
Sublingual haematomas, though uncommon, represent potentially serious complications arising from warfarin therapy.Distinguishing sublingual haematomas from infectious processes requires a high level of clinical suspicion and is crucial for prompt management.The preferred course of action involves reversing anticoagulation with a low threshold for implementing an artificial airway in cases of compromised airways.
上呼吸道自发性出血是慢性抗凝治疗罕见且可能危及生命的并发症。文献中仅有少数病例显示使用华法林后出现上呼吸道血肿，尽管华法林具有复杂的药代动力学和药效学特征，但它仍是临床医生使用的主要抗凝剂。我们报告了一例令人关注的病例，该病例为华法林诱发的舌下血肿，通过输注新鲜冰冻血浆逆转抗凝，并在重症监护病房（ICU）进行密切监测，采取保守治疗。
舌下血肿虽不常见，但却是华法林治疗可能引发的严重并发症。将舌下血肿与感染性疾病相鉴别需要高度的临床怀疑，这对及时治疗至关重要。首选的治疗措施包括逆转抗凝，对于气道受损的病例，应低阈值实施人工气道。
