Warfarin-induced vasculitis: A dose-related phenomenon in susceptible individuals?

Abstract

Summary A case of warfarin-induced skin vasculitis in a 52-year-old female is reported. Bilateral breast involvement occurred but without progression to necrosis as in previously described cases. The pathogenesis is discussed and prescribing recommendations made in an attempt to avoid the complication in susceptible individuals.

Warfarin-induced Leukocytoclastic Vasculitis: A Case Report and Review of Literature

“…Furosemide may prevent warfarin from binding to plasma proteins (mainly albumin) and therefore increase its availability and anticoagulant effect. A dose-dependency of drug-induced vasculitis has been suggested in some case reports (4). From this point of view, the concomitant use of a medication with a potential drug interaction with warfarin might increase the risk of warfarininduced vasculitis in certain susceptible patients.…”

“…Ten reports were identified in the English-language literature from the years 1980 to 2011 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12). From the reports we collected the following data: patient age at onset, cutaneous manifestations, latency (from initiation of treatment to onset of skin manifestations), treatment strategies for vasculitis, concomitant medications, and outcome.…”

A case of leukocytoclastic vasculitis caused by novel anticoagulant rivaroxaban

“…A comprehensive review of existing literature revealed twenty-three cases of anticoagulant-induced LCV, including two attributed to rivaroxaban use (Table 1), [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. It is worth noting that along with our patient, one of the two reported patients with rivaroxabaninduced LCV was prescribed metformin, another drug rarely implicated as a cause of LCV, prior to the development of symptoms [26,28].…”

Ulcerative IgA vasculitis in the setting of warfarin therapy

“…Cutaneous necrosis is not a common finding in childhood HSP and has been reported in fewer than 5% of all cases [10]. Pillebout et al determined hemorrhagic necrotic purpura in 35% of adult HSP cases and suggested that the incidence of hemorrhagic necrotic skin lesions increases with age, similarly to renal involvement [2].…”