JAMES ZAGER, M.D.; T. B. TJANDRAMAGA, M.D.; S. A. CUCINELL, M.D.; PETER G. DAYTON, D.SC.
ZAGER J, TJANDRAMAGA TB, CUCINELL SA, DAYTON PG. Coumarin Resistance in a Negro Woman. Ann Intern Med. 1973;78:775-776. doi: 10.7326/0003-4819-78-5-775
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Published: Ann Intern Med. 1973;78(5):775-776.
To the editor: Two white families with hereditary coumarin resistance have been reported (1, 2). We found a 27-year-old negro woman who apparently has this trait. She had normal prothrombin time despite sodium warfarin therapy (Coumadin⌖, 15 to 20 mg/ day).
Anticoagulation was tried in view of her mitral valve prosthesis with residual aortic regurgitation; paroxysmal tachycardia was controlled with quinidine sulfate (800 mg/day). She was also receiving digoxin, penicillin (for prophylaxis, to prevent recurrence of rheumatic fever), trichlormethiazide as a diuretic, and KC1 supplement. The oral anticoagulant was changed to bishydroxycoumarin (Dicoumarol⌖) for easier measurement of plasma levels (3).
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