Clinicians should be aware of rare but potentially life-threatening oral bleeding lesions induced by anticoagulants like warfarin, especially in older patients on multiple medications.
Highlights oral bleeding nodules as a rare but severe complication of supratherapeutic anticoagulation; leaves open the.
Warfarin is an anticoagulant used to prevent thrombosis, cardiac arrhythmias, atrial fibrillation, and recurrence of pulmonary embolism. A 69-year-old male patient reported episodes of four heart attacks, stroke, pulmonary emphysema, varicose veins, thyroid dysfunction, and a history of angioplasty. They use daily dose of 5 mg. Intraoral clinical examination revealed a bleeding nodular lesion of purple color with irregular borders and a smooth surface. The prothrombin time was 68.9 seconds, activity was 10%, and the international normalized ratio (INR) was 8.26. Based on these results, the patient received a single dose of 2.5 mg vitamin K via subcutaneous route. The final diagnosis was oral anticoagulant-induced lesions. Clinicians should be familiar with the side effects of anticoagulants, which are rare in the oral cavity, but can be life-threatening if diagnosed late or inaccurately, especially in older patients that often use many drugs.KeywordsAnticoagulant; Hemorrhage; Warfarin; Mouth.
No takes yet. Share an insight, caveat, or question.
Costa et al. (2017) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: