title: [A case of a patient with bladder cancer who received warfarin and showed a significantly prolonged PT-INR after gemcitabine and cisplatin combination therapy].
abstract: A 74-year-old female patient with bladder cancer presented with edema in the right lower limb in a follow-up at the outpatient department.She was diagnosed with deep vein thrombosis in the right lower limb, and warfarin treatment was started.Subsequent gemcitabine and cisplatin combination(GC)therapy for prevention of bladder cancer recurrence prolonged the PT-INR to an immeasurable level on day 6 of therapy.Thus, warfarin was immediately discontinued and a single dose of menatetrenone was administered.Subsequently, the PT-INR recovered to 1.36 one day after discontinuation of warfarin.In the second course of GC therapy, warfarin was discontinued before administration of the anticancer drugs, and there was no change in the PT-INR.The abnormally high PT-INR observed in the early stage after GC therapy in this case shows that it is important to monitor blood coagulation from immediately after administration of GC therapy in a patient under treatment with warfarin.
authors.affiliation: Dept. of Pharmacy, Nagasaki Municipal Hospital, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yoshioka
authors.forename: Mariko
authors.initials: M
authors.lastname: Kinoshita
authors.forename: Masanobu
authors.initials: M
authors.lastname: Ogawa
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Tsuruta
authors.forename: Ayumi
authors.initials: A
authors.lastname: Ozeki
authors.forename: Akemi
authors.initials: A
authors.lastname: Morita
authors.forename: Koichiro
authors.initials: K
authors.lastname: Nomata
authors.forename: Hiroko
authors.initials: H
authors.lastname: Dakeshita
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004487:Edema / Q000209:etiology; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D007866:Leg; D011516:Prothrombin / Q000378:metabolism; D013924:Thrombophlebitis / Q000150:complications / Q000188:drug therapy* / Q000201:enzymology; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy*; D014859:Warfarin / Q000627:therapeutic use*; D000093542:Gemcitabine
chemical_list: D000925:Anticoagulants; D003841:Deoxycytidine; D014859:Warfarin; D011516:Prothrombin; D002945:Cisplatin; D000093542:Gemcitabine