Diffuse Alveolar Hemorrhage Caused by Warfarin After Rifampicin Discontinuation

Overview

Journal Case Rep Med

Publisher Wiley

Specialty General Medicine

Date 2019 Feb 28

PMID 30809261

Citations 5

Authors

Takashige Kiyota

Seiji Shiota

Ryosuke Hamanaka

Daisuke Tsutsumi

Takeshi Takakura

Eishi Miyazaki

Affiliations

Soon will be listed here.

Abstract

An 83-year-old man under warfarin therapy presented for assessment of prolonged prothrombin time and cough. High-resolution computed tomography findings of the chest showed diffuse alveolar hemorrhage. His international normalized ratio (INR) was 11.89. He had been treated with rifampicin for a persistent infection, but this had been discontinued about two months before admission. Rifampicin suppresses the anticoagulant activity of warfarin, which can lead to a need for increased doses of warfarin to achieve and maintain a therapeutic INR. More frequent INR monitoring is needed even after discontinuing rifampicin.

Citing Articles

Oral anticoagulants and concurrent rifampin administration in tuberculosis patients with non-valvular atrial fibrillation.

Hwang K, Choi J, Lee S, Lee S, Chon M, Lee J BMC Cardiovasc Disord. 2023; 23(1):182.

PMID: 37016321 PMC: 10074893. DOI: 10.1186/s12872-023-03212-z.

Genetic Polymorphism Effect on Warfarin-Rifampin Interaction: A Case Report and Review of Literature.

Salem M, Eljilany I, El-Bardissy A, Elewa H Pharmgenomics Pers Med. 2021; 14:149-156.

PMID: 33542643 PMC: 7851577. DOI: 10.2147/PGPM.S288918.

Strategies and Advances in Combating COVID-19 in China.

Liu W, Guan W, Zhong N Engineering (Beijing). 2020; 6(10):1076-1084.

PMID: 33078078 PMC: 7558233. DOI: 10.1016/j.eng.2020.10.003.

Dynamic relationship between D-dimer and COVID-19 severity.

Li Y, Zhao K, Wei H, Chen W, Wang W, Jia L Br J Haematol. 2020; 190(1):e24-e27.

PMID: 32420615 PMC: 7276819. DOI: 10.1111/bjh.16811.

An interesting case of gluteal haematoma.

Sahu K, Mishra A, Lal A, Davuluri V BMJ Case Rep. 2019; 12(8).

PMID: 31375506 PMC: 6677962. DOI: 10.1136/bcr-2019-230282.

References

Lee C, Thrasher K . Difficulties in anticoagulation management during coadministration of warfarin and rifampin. Pharmacotherapy. 2001; 21(10):1240-6. DOI: 10.1592/phco.21.15.1240.33897. View

Nutescu E, Shapiro N, Ibrahim S, West P . Warfarin and its interactions with foods, herbs and other dietary supplements. Expert Opin Drug Saf. 2006; 5(3):433-51. DOI: 10.1517/14740338.5.3.433. View

Ohno Y, Hisaka A, Ueno M, Suzuki H . General framework for the prediction of oral drug interactions caused by CYP3A4 induction from in vivo information. Clin Pharmacokinet. 2008; 47(10):669-80. DOI: 10.2165/00003088-200847100-00004. View

Leveque D, Lemachatti J, Nivoix Y, Coliat P, Santucci R, Ubeaud-Sequier G . [Mechanisms of pharmacokinetic drug-drug interactions]. Rev Med Interne. 2009; 31(2):170-9. DOI: 10.1016/j.revmed.2009.07.009. View

Krajewski K . Inability to achieve a therapeutic INR value while on concurrent warfarin and rifampin. J Clin Pharmacol. 2010; 50(6):710-3. DOI: 10.1177/0091270009353030. View

Waness A, Aldabbagh T, Harakati M . Diffuse alveolar haemorrhage secondary to warfarin therapy for atrial fibrillation: a case report and literature review. BMJ Case Rep. 2011; 2009. PMC: 3028302. DOI: 10.1136/bcr.08.2008.0757. View

Ageno W, Gallus A, Wittkowsky A, Crowther M, Hylek E, Palareti G . Oral anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012; 141(2 Suppl):e44S-e88S. PMC: 3278051. DOI: 10.1378/chest.11-2292. View

Martins M, Reis A, Sales M, Nobre V, Ribeiro D, Rocha M . Rifampicin-warfarin interaction leading to macroscopic hematuria: a case report and review of the literature. BMC Pharmacol Toxicol. 2013; 14:27. PMC: 3653703. DOI: 10.1186/2050-6511-14-27. View

Maina M, Pastakia S, Manji I, Kirui N, Kirwa C, Karwa R . Describing the profile of patients on concurrent rifampin and warfarin therapy in western Kenya: a case series. Drugs R D. 2013; 13(3):191-7. PMC: 3784049. DOI: 10.1007/s40268-013-0023-7. View

10.

Uysal E, Cevik E, Solak S, Acar Y, Yalimol M . A life-threatening complication of warfarin therapy in ED: diffuse alveolar hemorrhage. Am J Emerg Med. 2014; 32(6):690.e3-4. DOI: 10.1016/j.ajem.2013.12.022. View

11.

Kaya B, Yildiz I, Baha R, Zeytun N, Yetisgen A . Diffuse Alveolar Hemorrhage Associated with Warfarin Therapy. Case Rep Med. 2015; 2015:350532. PMC: 4549538. DOI: 10.1155/2015/350532. View

12.

Chang S, Chou I, Yeh Y, Chiou M, Wen M, Kuo C . Association Between Use of Non-Vitamin K Oral Anticoagulants With and Without Concurrent Medications and Risk of Major Bleeding in Nonvalvular Atrial Fibrillation. JAMA. 2017; 318(13):1250-1259. PMC: 5818856. DOI: 10.1001/jama.2017.13883. View

13.

Poon M, Moffett B, Yee D . Warfarin-Rifampin Drug Interaction in a Pediatric Patient. J Pediatr Pharmacol Ther. 2017; 22(5):375-377. PMC: 5640306. DOI: 10.5863/1551-6776-22.5.375. View

14.

Harder S, Thurmann P . Clinically important drug interactions with anticoagulants. An update. Clin Pharmacokinet. 1996; 30(6):416-44. DOI: 10.2165/00003088-199630060-00002. View