Graves’ Disease and Treatment Effects on Warfarin Anticoagulation
Joint Authors
Choby, Beth A.
Luckey, Alexis
George, Christa
Howard-Thompson, Amanda
Self, Timothy H.
Source
Issue
Vol. 2014, Issue 2014 (31 Dec. 2014), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2014-06-04
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
Background.
Hyperthyroidism causes an increased hypoprothrombinemic response to warfarin anticoagulation.
Previous studies have demonstrated that patients with hyperthyroidism require lower dosages of warfarin to achieve a therapeutic effect.
As hyperthyroidism is treated and euthyroidism is approached, patients may require increasing warfarin dosages to maintain appropriate anticoagulation.
We describe a patient’s varying response to warfarin during treatment of Graves’ disease.
Case Presentation.
A 48-year-old African American female presented to the emergency room with tachycardia, new onset bilateral lower extremity edema, gradual weight loss, palpable goiter, and generalized sweating over the prior 4 months.
She was admitted with Graves’ disease and new onset atrial fibrillation.
Primary stroke prophylaxis was started using warfarin; the patient developed a markedly supratherapeutic INR likely due to hyperthyroidism.
After starting methimazole, her free thyroxine approached euthyroid levels and the INR became subtherapeutic.
She remained subtherapeutic over several months despite steadily increasing dosages of warfarin.
Immediately following thyroid radioablation and discontinuation of methimazole, the patient’s warfarin dose and INR stabilized.
Conclusion.
Clinicians should expect an increased response to warfarin in patients with hyperthyroidism and close monitoring of the INR is imperative to prevent adverse effects.
As patients approach euthyroidism, insufficient anticoagulation is likely without vigilant follow-up, INR monitoring, and increasing warfarin dosages.
American Psychological Association (APA)
Howard-Thompson, Amanda& Luckey, Alexis& George, Christa& Choby, Beth A.& Self, Timothy H.. 2014. Graves’ Disease and Treatment Effects on Warfarin Anticoagulation. Case Reports in Medicine،Vol. 2014, no. 2014, pp.1-6.
https://search.emarefa.net/detail/BIM-460963
Modern Language Association (MLA)
Howard-Thompson, Amanda…[et al.]. Graves’ Disease and Treatment Effects on Warfarin Anticoagulation. Case Reports in Medicine No. 2014 (2014), pp.1-6.
https://search.emarefa.net/detail/BIM-460963
American Medical Association (AMA)
Howard-Thompson, Amanda& Luckey, Alexis& George, Christa& Choby, Beth A.& Self, Timothy H.. Graves’ Disease and Treatment Effects on Warfarin Anticoagulation. Case Reports in Medicine. 2014. Vol. 2014, no. 2014, pp.1-6.
https://search.emarefa.net/detail/BIM-460963
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-460963