Article Text

Unexpected outcome (positive or negative) including adverse drug reactions
Diffuse alveolar haemorrhage secondary to warfarin therapy for atrial fibrillation: a case report and literature review
  1. Abdelkarim Waness1,
  2. Tarek Aldabbagh2,
  3. Mohammed Harakati3
  1. 1
    King Abdulaziz Medical City for National Guards, Internal Medicine - Code 1443, PO Box 22490, Riyadh 11426, Saudi Arabia
  2. 2
    King Abdulaziz Medical City, ICU, PO Box 22490, Riyadh 11426, Saudi Arabia
  3. 3
    King Abdulaziz Medical City, Medicine, PO Box 22490, Riyadh 11426, Saudi Arabia
  1. Abdelkarim Waness, n4a1w{at}


Alveolar haemorrhage is a rare and serious medical emergency with many causes. Diffuse alveolar haemorrhage due to warfarin therapy has been rarely reported in the literature. In this paper, we describe the case of 62-year-old woman with a history of chronic atrial fibrillation treated with warfarin, who was admitted to our institution with haemoptysis and dyspnoea. Alveolar haemorrhage was suspected clinically and subsequently confirmed by bronchoscopy. The patient required aggressive treatment with fresh frozen plasma, vitamin K and mechanical ventilation with a successful outcome. We emphasise the need for early diagnosis and fast therapeutic intervention, especially with over-anticoagulation (INR >9), in patients with this rare and potentially lethal condition.

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  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication.