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Published on: August 4, 2018
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Warfarin-induced gastrointestinal bleeding with acute liver failure: A case report
Jiahao Chen1, Le Li, Shiyu Wang
1Department of Pharmacy, The People's Hospital of Hezhou, Hezhou, China.
Medicine
|January 14, 2025
Summary
Warfarin-induced gastrointestinal bleeding and liver injury are rare but serious. Promptly stopping warfarin, adjusting the international normalized ratio (INR), and using liver support therapy can prevent liver failure.
Area of Science:
- Pharmacology
- Hepatology
- Gastroenterology
Background:
- Warfarin is a common anticoagulant for mechanical valve replacement.
- Acute liver damage from warfarin is rare but can be severe.
- This case highlights warfarin-induced gastrointestinal bleeding and liver injury.
Purpose of the Study:
- To report a rare case of warfarin-induced gastrointestinal bleeding with liver injury.
- To describe the management and therapy for this condition.
- To emphasize the importance of monitoring and intervention.
Main Methods:
- A 64-year-old woman with a mechanical mitral valve replacement presented with gastrointestinal bleeding and elevated INR.
- The patient developed acute liver injury.
- Treatment involved discontinuing warfarin, artificial liver support, and anti-inflammatory liver therapy.
Main Results:
- Liver enzymes and hyperbilirubinemia improved with treatment.
- Warfarin was restarted at a lower dose, with INR reaching 2.03.
- The patient was discharged on day 24 with no significant increase in liver enzymes.
Conclusions:
- Close monitoring of warfarin therapy and international normalized ratio (INR) is crucial.
- Prompt discontinuation of warfarin and appropriate liver support therapy can prevent warfarin-induced liver failure.
- Avoiding drug-drug interactions is essential in patients on warfarin.
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