Key result
A 68-year-old female on long-term warfarin developed a sublingual hematoma following a dental procedure despite a therapeutic INR of 2.54, which resolved with conservative management.
Why the study?
Pseudo-Ludwig angina due to anticoagulant use is rarely reported, and the safe INR range for intraoral interventions remains unclear.
Does warfarin use lead to pseudo-Ludwig angina after dental procedures in patients with therapeutic INR?
Case Report (n=1)
No
Does warfarin use lead to pseudo-Ludwig angina after dental procedures in patients with therapeutic INR?
Warfarin can cause severe bleeding complications such as pseudo-Ludwig angina after minor intraoral trauma, even when the INR is within the therapeutic range.
Clinicians should consider pseudo-Ludwig angina after dental trauma in anticoagulated patients despite normal INR; extends sparse reports but remains hypothesis-generating.
Pseudo-Ludwig angina is a swelling that develops generally due to a cause other than an infection and can lead to fatal conditions such as severe respiratory obstruction. Due to anticoagulant use is rarely reported in the literature. This study presented a patient whose INR value was within the normal range and who developed sublingual swelling after dental treatment (intraoral trauma). A 68-year-old female patient was admitted to the emergency department complaining of increasing intraoral swelling on examination with a sublingual 3x5 cm hematoma. Warfarin was stopped, and she was monitored for possible intubation risk in the service. The patient did not develop respiratory distress and was discharged 4 days later. The INR range within which intraoral interventions can be performed safely is still unclear. The dentist should keep in mind that such complications may develop and be prepared for bleeding complications before treatment using warfarin patients.
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Naser et al. (2023) conducted a case report in Pseudo-Ludwig Angina (n=1). Warfarin was evaluated. A 68-year-old female on long-term warfarin developed a sublingual hematoma following a dental procedure despite a therapeutic INR of 2.54, which resolved with conservative management.
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