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Bleeding from self-administration of phenindione: a detailed case study
British Journal of Haematology
|August 1, 1976
Summary
This study identified phenindione as the cause of a severe bleeding disorder in a young woman due to vitamin-K-dependent factor deficiencies. Treatment with a concentrate of factors II, IX, and X effectively controlled her bleeding symptoms.
Area of Science:
- Biochemistry
- Hematology
- Clinical Pharmacology
Background:
- A young woman presented with a severe, long-standing bleeding disorder.
- She exhibited significant deficiencies in all four vitamin-K-dependent clotting factors.
Observation:
- Metabolic studies using tritium-labelled vitamin K1 indicated potential oral anticoagulant use.
- Plasma analysis revealed a substance with properties identical to phenindione.
Findings:
- The patient's clotting factor deficiencies were attributed to phenindione overdose.
- Half-disappearance times for factors II, IX, and X were consistent with established data.
- Administration of a concentrate containing factors II, IX, and X successfully managed her bleeding.
Implications:
- Phenindione overdose can cause severe bleeding disorders due to vitamin-K-dependent factor deficiencies.
- Factor VII may not be critical for reversing anticoagulant-induced bleeding.
- This case highlights the importance of identifying drug-induced coagulopathies.
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