Genetic resistance to warfarin therapy masked by amiodarone in a 2-year-old girl with mitral valve replacement

Moreau, Caroline; Bajolle, Fanny; Siguret, Virginie; Loriot, Marie‐Anne; Bonnet, Damien

doi:10.1111/jth.12105

Cited by 4 publications

(2 citation statements)

References 11 publications

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“… 6 However, such exam is not routinely made in our institution and more studies are required in children. 6 , 8 It is worth noting that VKORC and CYP2C9 gene polymorphism screening have been issued as an essential laboratory test before initiating warfarin. 9 , 10 While the clinical value of such exam has been associated with improved safety, 9 , 10 the cost-effectiveness 11 of universal testing of patients initiating vitamin K antagonists still is to be determined, especially in public health systems.…”

Section: Discussionmentioning

confidence: 99%

Dose Não Usual De Varfarina Para Alcançar Rni Terapêutica Em Uma Criança De Quatro Meses: Fatores De Risco Não Genéticos Ainda São Um Desafio

Okumura

Negretto

Carvalho

2017

Rev. paul. pediatr.

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Objective: To report a case of a 4-month old girl that required 0.7 mg/kg/day (5 mg) of warfarin and discuss relevant risk factors for requiring higher doses.Case Description: In November 2015, a 5 kg female infant (36-week preterm) was admitted to the hospital due to status epilepticus and fever. Diazepam, phenytoin and ceftriaxone were prescribed. Cerebrospinal fluid contained 7 leukocytes, 150 mg/dL proteins, 1 mg/dL glucose and gram positive cocci were observed. Cranial tomography suggested hypodense signs in the cerebellum, right temporal lobe and left basal nuclei, which was consistent with pneumococcal meningitis-induced infectious vasculitis. She required low molecular weight heparin and warfarin for post-encephalitis thrombosis. About 10 days were required to achieve therapeutic INR, and warfarin was adjusted five times since the initial prescription.Comments: The risk factors for higher warfarin doses were age and enteral tube feeding. Phenobarbital and prednisone might also have contributed with one of the highest warfarin dose ever reported. Despite current importance given to genetics testing, clinicians should attempt to identify common contributing factors for prolonged non-therapeutic INR, to minimize the risk of coagulation, and to reduce costs of hospital stay and laboratory exams.

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Section: Discussionmentioning

confidence: 99%

Dose Não Usual De Varfarina Para Alcançar Rni Terapêutica Em Uma Criança De Quatro Meses: Fatores De Risco Não Genéticos Ainda São Um Desafio

Okumura

Negretto

Carvalho

2017

Rev. paul. pediatr.

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“…[88]. * A case report, which includes a 2-year-old girl, is not included [117]. ** A report of two cases was not used due to its imprecision on the doses [118].…”

Section: Vkorc1 Human Genotypesmentioning

confidence: 99%

Comparative Biology of the Resistance to Vitamin K Antagonists: An Overview of the Resistance Mechanisms

Lefebvre¹,

Benoît²,

Lattard³

2016

Anticoagulation Therapy

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Vitamin K antagonists VK" are used in human medicine as well as for the management of rodent populations. In both cases, we have to deal with inter-individual resistances. Many mechanisms of resistances are common in humans and rodents. Moreover, with the large use of vitamin K antagonist rodenticides, the resistant phenotype is overrepresented in some rodent populations. Consequently, some resistance mechanisms with a low prevalence in the human population have a higher prevalence in rodent population thus, they can be more studied in rodents. The aim of this chapter is to cross knowledge coming from human medicine and rodent research in order to better understand each resistance mechanism. "fter an overview of the essential knowledge for the understanding of the VK" action, this chapter presents the different methods of VK" resistance studying and then it assesses the current knowledge on VK" resistance in humans and rodents.

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Amiodarone/warfarin interaction

2013

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Genetic resistance to warfarin therapy masked by amiodarone in a 2-year-old girl with mitral valve replacement

Cited by 4 publications

References 11 publications

Dose Não Usual De Varfarina Para Alcançar Rni Terapêutica Em Uma Criança De Quatro Meses: Fatores De Risco Não Genéticos Ainda São Um Desafio

Dose Não Usual De Varfarina Para Alcançar Rni Terapêutica Em Uma Criança De Quatro Meses: Fatores De Risco Não Genéticos Ainda São Um Desafio

Comparative Biology of the Resistance to Vitamin K Antagonists: An Overview of the Resistance Mechanisms

Amiodarone/warfarin interaction

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