title: [Subarachnoid hemorrhage following commencement of danazol treatment in a patient well controlled on warfarin anticoagulation].
abstract: A 45-year-old woman with prosthetic valves replacement, was admitted with severe headache and vomiting one month after starting danazol treatment at 300 mg per day. She was receiving long-term anticoagulation with warfarin and dipyridamole, taking 3.5 mg and 300 mg per day respectively. The patient's thrombotest value was less than 6% at the time of admission. Cranial CT revealed subarachnoid hemorrhage. Warfarin and danazol treatment ware discontinued with replenishment of vitamin K. Recovery was uneventful. Danazol is 2, 3 isoxazol derivative of 17-alpha-ethinyl testosterone. As such, it shares the property of C 17 alkylated steroids in potentiating the action of coumarin. It is suggested that danazol affects the turnover of vitamin-K-dependent clotting factors, an impairment of synthesis being a likely mechanism. The possible hazard of the potentiating effect of danazol on warfarin should be widely appreciated.
authors.affiliation: Department of Cardiovascular Surgery, Yokohama Seibu Hospital, St. Marianna University School of Medicine.
authors.forename: S
authors.initials: S
authors.lastname: Hinata
authors.forename: T
authors.initials: T
authors.lastname: Hiekata
authors.forename: S
authors.initials: S
authors.lastname: Kamata
authors.forename: T
authors.initials: T
authors.lastname: Mieda
mesh_terms: D001022:Aortic Valve Insufficiency / Q000601:surgery; D001777:Blood Coagulation / Q000187:drug effects*; D003613:Danazol / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery; D013345:Subarachnoid Hemorrhage / Q000139:chemically induced*; D014859:Warfarin / Q000627:therapeutic use*
chemical_list: D014859:Warfarin; D003613:Danazol