Acute Warfarin Toxicity as Initial Manifestation of Metastatic Liver Disease
Near complete infiltration of the liver secondary to metastasis from the head and neck cancer is a rare occurrence. The prognosis of liver failure associated with malignant infiltration is extremely poor; the survival time of patients is extremely low. We present a case of acute warfarin toxicity as...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Critical Care |
| Online Access: | http://dx.doi.org/10.1155/2016/7389087 |
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| _version_ | 1832548923596603392 |
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| author | Varalaxmi Bhavani Nannaka Nihar Jani Masooma Niazi Dmitry Lvovsky |
| author_facet | Varalaxmi Bhavani Nannaka Nihar Jani Masooma Niazi Dmitry Lvovsky |
| author_sort | Varalaxmi Bhavani Nannaka |
| collection | DOAJ |
| description | Near complete infiltration of the liver secondary to metastasis from the head and neck cancer is a rare occurrence. The prognosis of liver failure associated with malignant infiltration is extremely poor; the survival time of patients is extremely low. We present a case of acute warfarin toxicity as initial manifestation of metastatic liver disease. Our patient is a 64-year-old woman presenting with epigastric pain and discomfort, found to have unrecordable International Normalized Ratio. She rapidly deteriorated with acute respiratory failure requiring mechanical ventilation, profound shock requiring high dose vasopressor infusion, severe coagulopathy, worsening liver enzymes with worsening of lactic acidosis and severe metabolic abnormalities, and refractory to aggressive supportive care and died in less than 48 hours. Autopsy revealed that >90% of the liver was replaced by tumor masses. |
| format | Article |
| id | doaj-art-d9fab495a0de4ace96447cc8503fb383 |
| institution | Kabale University |
| issn | 2090-6420 2090-6439 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Critical Care |
| spelling | doaj-art-d9fab495a0de4ace96447cc8503fb3832025-02-03T06:12:41ZengWileyCase Reports in Critical Care2090-64202090-64392016-01-01201610.1155/2016/73890877389087Acute Warfarin Toxicity as Initial Manifestation of Metastatic Liver DiseaseVaralaxmi Bhavani Nannaka0Nihar Jani1Masooma Niazi2Dmitry Lvovsky3Division of Pulmonary and Critical Care Medicine, Bronx Lebanon Hospital Center, Bronx, NY 10457, USADepartment of Internal Medicine, Bronx Lebanon Hospital Center, Bronx, NY 10457, USADepartment of Pathology and Histology, Bronx Lebanon Hospital Center, Bronx, NY 10457, USADivision of Pulmonary and Critical Care Medicine, Bronx Lebanon Hospital Center, Bronx, NY 10457, USANear complete infiltration of the liver secondary to metastasis from the head and neck cancer is a rare occurrence. The prognosis of liver failure associated with malignant infiltration is extremely poor; the survival time of patients is extremely low. We present a case of acute warfarin toxicity as initial manifestation of metastatic liver disease. Our patient is a 64-year-old woman presenting with epigastric pain and discomfort, found to have unrecordable International Normalized Ratio. She rapidly deteriorated with acute respiratory failure requiring mechanical ventilation, profound shock requiring high dose vasopressor infusion, severe coagulopathy, worsening liver enzymes with worsening of lactic acidosis and severe metabolic abnormalities, and refractory to aggressive supportive care and died in less than 48 hours. Autopsy revealed that >90% of the liver was replaced by tumor masses.http://dx.doi.org/10.1155/2016/7389087 |
| spellingShingle | Varalaxmi Bhavani Nannaka Nihar Jani Masooma Niazi Dmitry Lvovsky Acute Warfarin Toxicity as Initial Manifestation of Metastatic Liver Disease Case Reports in Critical Care |
| title | Acute Warfarin Toxicity as Initial Manifestation of Metastatic Liver Disease |
| title_full | Acute Warfarin Toxicity as Initial Manifestation of Metastatic Liver Disease |
| title_fullStr | Acute Warfarin Toxicity as Initial Manifestation of Metastatic Liver Disease |
| title_full_unstemmed | Acute Warfarin Toxicity as Initial Manifestation of Metastatic Liver Disease |
| title_short | Acute Warfarin Toxicity as Initial Manifestation of Metastatic Liver Disease |
| title_sort | acute warfarin toxicity as initial manifestation of metastatic liver disease |
| url | http://dx.doi.org/10.1155/2016/7389087 |
| work_keys_str_mv | AT varalaxmibhavaninannaka acutewarfarintoxicityasinitialmanifestationofmetastaticliverdisease AT niharjani acutewarfarintoxicityasinitialmanifestationofmetastaticliverdisease AT masoomaniazi acutewarfarintoxicityasinitialmanifestationofmetastaticliverdisease AT dmitrylvovsky acutewarfarintoxicityasinitialmanifestationofmetastaticliverdisease |