MARY LEE, PHARM.D.; ROWEENA N. SCHWARTZ; ROOHOLLAH SHARIFI, M.D.
To the editor: Recently, cases of warfarin resistance due to unrecognized vitamin K supplementation in liquid nutrition products have been described (1, 2). These reports came coincidentally, as we were managing a patient with apparent anticoagulant resistance due to the same cause. She was a 70-year-old woman who had had pelvic exenteration for carcinoma of the proximal urethra. Over the next 3 weeks she received 3 L of crystalline amino acid solution without vitamin K supplementation, and a 14-day course of chloramphenicol for treatment of Bacteroides fragilis septicemia. During her convalescence she developed an acute episode of deep venous thrombosis
LEE M, SCHWARTZ RN, SHARIFI R. Warfarin Resistance and Vitamin K. Ann Intern Med. ;94:140–141. doi: 10.7326/0003-4819-94-1-140_3
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Published: Ann Intern Med. 1981;94(1):140-141.
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