Warfarin Resisance and Recurrent Thrombosis in an Iranian Patient

Warfarin resisance was known as subtherapeutic INR (International Normalized Ratio) in spite of normally prescribed doses of warfarin. There are few reports of warfarin resisance from Iran. In this article, we report a 43-year-old man with a hisory of deep vein thrombosis who took 10 mg of warfarin...

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Main Authors: Masuod Malekzadeh, Marzieh Pazoki
Format: Article
Language:English
Published: Tehran University of Medical Sciences 2019-01-01
Series:Case Reports in Clinical Practice
Subjects:
Online Access:https://crcp.tums.ac.ir/index.php/crcp/article/view/214
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author Masuod Malekzadeh
Marzieh Pazoki
author_facet Masuod Malekzadeh
Marzieh Pazoki
author_sort Masuod Malekzadeh
collection DOAJ
description Warfarin resisance was known as subtherapeutic INR (International Normalized Ratio) in spite of normally prescribed doses of warfarin. There are few reports of warfarin resisance from Iran. In this article, we report a 43-year-old man with a hisory of deep vein thrombosis who took 10 mg of warfarin and 120 mg of enoxaparin daily. He was presented with new acute deep vein thrombosis while taking anticoagulants. Despite warfarin dose increase to 50 mg, the INR did not achieve the therapeutic level. His genetic tesing was negative for VKORC1 mutation but positive for CYP2C9*3, which proposed other underlying mechanisms for his warfarin resisance. This report added to the cases of warfarin resisance in Iran and herald more attention to warfarin metabolism and its interaction. Also it calls for checking serum warfarin level and Factor II and Factor X level for better evaluating compliance in patients presented with warfarin resistance.
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spelling doaj.art-a3201db95286415dacf74c5447e9296d2022-12-22T03:21:45ZengTehran University of Medical SciencesCase Reports in Clinical Practice2538-26832538-26912019-01-0133Warfarin Resisance and Recurrent Thrombosis in an Iranian PatientMasuod Malekzadeh0Marzieh Pazoki1Digestive Disease Research Center Digestive Disease Research Institute, Shariati Hospital , Tehran University of Medical Sciences, Tehran, IranDepartment of Pulmonary and Critical Care Medicine, Sina Medical Center, Tehran University of Medical Sciences, Tehran, Iran.Warfarin resisance was known as subtherapeutic INR (International Normalized Ratio) in spite of normally prescribed doses of warfarin. There are few reports of warfarin resisance from Iran. In this article, we report a 43-year-old man with a hisory of deep vein thrombosis who took 10 mg of warfarin and 120 mg of enoxaparin daily. He was presented with new acute deep vein thrombosis while taking anticoagulants. Despite warfarin dose increase to 50 mg, the INR did not achieve the therapeutic level. His genetic tesing was negative for VKORC1 mutation but positive for CYP2C9*3, which proposed other underlying mechanisms for his warfarin resisance. This report added to the cases of warfarin resisance in Iran and herald more attention to warfarin metabolism and its interaction. Also it calls for checking serum warfarin level and Factor II and Factor X level for better evaluating compliance in patients presented with warfarin resistance.https://crcp.tums.ac.ir/index.php/crcp/article/view/214Warfarin resistanceIran
spellingShingle Masuod Malekzadeh
Marzieh Pazoki
Warfarin Resisance and Recurrent Thrombosis in an Iranian Patient
Case Reports in Clinical Practice
Warfarin resistance
Iran
title Warfarin Resisance and Recurrent Thrombosis in an Iranian Patient
title_full Warfarin Resisance and Recurrent Thrombosis in an Iranian Patient
title_fullStr Warfarin Resisance and Recurrent Thrombosis in an Iranian Patient
title_full_unstemmed Warfarin Resisance and Recurrent Thrombosis in an Iranian Patient
title_short Warfarin Resisance and Recurrent Thrombosis in an Iranian Patient
title_sort warfarin resisance and recurrent thrombosis in an iranian patient
topic Warfarin resistance
Iran
url https://crcp.tums.ac.ir/index.php/crcp/article/view/214
work_keys_str_mv AT masuodmalekzadeh warfarinresisanceandrecurrentthrombosisinaniranianpatient
AT marziehpazoki warfarinresisanceandrecurrentthrombosisinaniranianpatient