Key result
A 72-year-old woman on warfarin for recurrent deep vein thrombosis presented with a supra-therapeutic INR >8.0 despite a recent dose reduction.
Case Report (n=1)
Highlights the clinical challenge of managing supra-therapeutic INR in a patient on warfarin for recurrent DVT.
Urgent INR reversal and cause investigation needed to avert bleeding; leaves open optimal monitoring protocols in elderly warfarin patients.
#### The bottom line A 72 year old woman, who had been diagnosed as having recurrent deep vein thrombosis six weeks earlier, attends the practice’s phlebotomy clinic for an international normalised ratio (INR) check. Her INR is greater than 8.0 (target INR range: 2.0-3.0). During the consultation, you look through her previous INR readings and notice they have been supra-therapeutic over the past two weeks despite a reduction in the dose of warfarin.
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Reddy et al. (2015) conducted a case report in Recurrent deep vein thrombosis (n=1). Warfarin was evaluated on INR level. A 72-year-old woman on warfarin for recurrent deep vein thrombosis presented with a supra-therapeutic INR >8.0 despite a recent dose reduction.
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