Acenocoumarol-Induced Diffuse Alveolar Hemorrhage: A Case Report

Abstract

Diffuse alveolar hemorrhage (DAH) is bleeding into the alveolar spaces of the lung. DAH is often associated with systemic autoimmune diseases, coagulation disorders, drugs, inhaled toxins, or transplantation. This study describes a rare case of acenocoumarol-induced DAH, a pulmonary disorder, which has not been reported before. A 48-year-old male presented with a history of rheumatic heart disease with mitral stenosis with moderate mitral regurgitation status post mitral valve replacement. He was taking acenocoumarol but did not keep his prothrombin time-international normalized ratio (PT-INR) monitoring and came to the hospital with complaints of cough, hemoptysis, and breathlessness. Chest x-ray and high-resolution computed tomography (HRCT) thorax were done which revealed diffuse patchy opacities and pulmonary hemorrhage, respectively. After nine days of hospital stay with appropriate management with corticosteroids, antibiotics, and intravenous fluids, the patient was doing well.

Chemical Pneumonitis and Reactive Airways Dysfunction Syndrome After Fumigation Exposure to Dimethanol and Glutaraldehyde: A Silent Menace Unmasked

“…There are case reports of diffused alveolar damage due to drugs like acenocoumarol [ 7 ]. Interstitial pneumonitis sometimes may be confused with chemical pneumonitis which can happen after viral fever [ 8 ].…”