Concluded Case

Update to the previous case

After careful interview (2nd time), patient revealed he had nose bleeds & gingival bleeding in last 7-8 months and had been suffering from hematochezia from 2 days Physical Examination During investigation physical examination of mouth was missed. When performed it revealed Dry mouth. Investigations (As suggested by Dr. Pushker bhomia Sir) Investigations were done for finding the cause of hematuria and cause was found to be drug induced hematuria. Drug induced in the sense because of warfarin in dosage of patient (As directed by Dr. Purnanandam Yedavally Sir ): USG was performed and came negative for any anomalies and abnormalities. BT, CT, PT & INR was performed on the patient. INR(PT) level was 3.5 which revealed that warfarin was causing too much thinning of blood. BT, CT tests revealed higher bleeding & clotting times (suspecting a deficiency of Vit. K). A serum biochemical profile was done on the patient which revealed Vit. K levels below normal range confirming Vit. K deficiency. Diagnosis Dx came to be Warfarin - associated coagulopathy with drug induced hematuria and Vit. K deficiency Management Prothrombin complex concentrate 50 UI/Kg IV Vit. K antagonist dechallenge Vit. K 5-10 mg IV Continuous Infusion Monitoring of Vital Signs (As said by Dr. Kute Ankush Sir) Zenflox-UTI Multivitamins & Antioxidants (As Directed by Dr. Md Altaf Hussain Sir) Warfarin dosage was removed

(Edited)

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Concluded answer

Thank you very much @Dr. Pushker Bhomia Sir Dr. Purnanandam Yedavally Sir Dr. Kute Ankush Sir Dr. Md Altaf Hussain Sir For helping and sharing your knowledge in solving the case.

All Answers

NEED'S TO .. ADD .. VITAMIN K1 .. ORALLY ..

I agree with you Sir
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Great Why he is taking warfarin? There are no of safe alternative now.

Sir It was prescribed by other physician (according to him)
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Continue your treatment good one

Thank you doctor
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Thank you Doctor for mentioning names after follow up., This shows your respect and humble attitude... I want you to be the best doctor!

Thank you doctor
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Thank you very much @Dr. Pushker Bhomia Sir Dr. Purnanandam Yedavally Sir Dr. Kute Ankush Sir Dr. Md Altaf Hussain Sir For helping and sharing your knowledge in solving the case.

Thanx sir
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