Abstract Hemorrhagic complications of oral anticoagulant therapy are well known. The purpose of this communication is to report an unusual and potentially life-threatening complication of long-term anticoagulant therapy that, as far as we know, has not been previously reported in the pediatric literature. Report of a Case.—A 17-year-old girl was admitted to the hospital because of a rapidly decreasing hematocrit reading and abdominal pain. She was known to have rheumatic heart disease since age 7 years, and at 13 years of age, her mitral valve was replaced with a Björk-Shiley artificial valve. Postoperatively, she was given daily penicillin G potassium and warfarin sodium. Two months prior to admission, the patient had a transient episode of cerebral ischemia after poor compliance with her warfarin regimen. Her warfarin dose was increased, and she subsequently did well, with prothrombin times that were 2½ times control values. One month prior to admission, she had References 1. Gurewich V, Thomas D: Massive intraperitoneal hemorrhage from a ruptured corpus luteum . N Engl J Med 263:909-910, 1960.Crossref 2. Weseley AC, Neustadter MI, Levine W: Massive intraperitoneal hemorrhage of ovarian follicular origin during anticoagulant therapy . Am J Obstet Gynecol 73:683-685, 1957. 3. Rosenthal AH: Rupture of the corpus luteum, including four cases of massive intraperitoneal hemorrhage . Am J Obstet Gynecol 79:1008-1011, 1960. 4. Krause JR, Amores R: Massive intraperitoneal hemorrhage from ruptured corpus luteum during anticoagulant therapy . South Med J 69:1220-1221, 1976.Crossref 5. Perlman JA, Barnes AB, Demirjian Z: Corpus luteum hemorrhages complicating chronic anticoagulation . Obstet Gynecol 49( (suppl) ):20-21, 1977. 6. Wong K, Gillett PG: Recurrent hemorrhage from corpus luteum during anticoagulant therapy . Can Med Assoc J 116:388-390, 1977. 7. Lee RA, Kazmier FJ: Ovarian hematoma complicating anticoagulant therapy . Mayo Clin Proc 52:19-23, 1977. 8. Semchyshyn S, Zuspan F: Ovarian hemorrhage due to anticoagulants . Am J Obstet Gynecol 131:837-844, 1978. 9. Kakkar VV, Field ES, Nicolaides AN, et al: Low doses of heparin in prevention of deep-vein thrombosis . Lancet 2:669-671, 1971.Crossref 10. Kakkar VV, Corrigan TP, Fossard DP: Prevention of fatal postoperative pulmonary embolism by low doses of heparin: An international multicentre trial . Lancet 2:45-51, 1975. 11. Goldzieher JW, Dozier TS: Oral contraceptives and thromboembolism: A reassessment . Am J Obstet Gynecol 123:878-914, 1975. 12. Sartwell PE, Masi AT, Arthur FG, et al: Thromboembolism and oral contraceptives: An epidemiologic case control study . Am J Epidemiol 90:365-380, 1969. 13. Coon WW, Willis PW III, Keller JB: Venous thromboembolism and other venous disease in the Tecumseh Community Health Study . Circulation 48:839-846, 1973.Crossref
American Journal of Diseases of Children – American Medical Association
Published: May 1, 1980
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