Korean Circ J.  2011 Feb;41(2):109-112. 10.4070/kcj.2011.41.2.109.

Warfarin-Induced Eosinophilic Pleural Effusion

• Jo YM
• Park TH
• Jeong IH
• Kim HJ
• Ahn JH
• Kim WJ
• Cho YR
• Baek HK
• Kim MH
• Kim YD

• KMID: 2225145
• DOI: http://doi.org/10.4070/kcj.2011.41.2.109

Abstract

A 29-year-old man suffering from dyspnea and eosinophilic pleural effusion after being on warfarin for pulmonary thromboembolism for a period of one month, was readmitted to our hospital. Etiology of pleural effusion other than warfarin was excluded. To the best of our knowledge, this is the first case of warfarin-induced pleural effusion reported in Korea.

Keyword

Warfarin; Pleural effusion

MeSH Terms

Adult
Dyspnea
Eosinophils
Humans
Korea
Pleural Effusion
Pulmonary Embolism
Stress, Psychological
Warfarin
Warfarin

Figure

• 

  Fig. 1 Chest computed tomography showed pulmonary thromboembolism of the right main pulmonary artery and right middle and lower lobar artery.

• 

  Fig. 2 Chest X-ray demonstrated a large right pleural effusion on current admission (A) and scanty pleural effusion before the warfarin administration (B).

• 

  Fig. 3 The quantity of the drained pleural fluid changed after the administration of warfarin.

• 

  Fig. 4 The change in PT-INR and dosage of warfarin during admission. PT-INR: prothrombin time-international normalized ratio.

Reference

1. Cooper JA Jr, White DA, Matthay RA. Drug-induced pulmonary disease (part I & II). Am Rev Respir Dis. 1986. 133:488–505.

2. Moufarrege G, Frank E, Carstens DD. Eosinophilic exudative pleural effusion after initiation of tizanidine treatment: a case report. Pain Med. 2003. 4:85–90.

3. Anshelevich IV, Svistunova AA. Eosinophilic exudative pleurisy as a manifestation of drug allergy. Ter Arkh. 1986. 58:142–143.

4. Huggins JT, Sahn SA. Drug-induced pleural disease. Clin Chest Med. 2004. 25:141–153.

5. You SH, Hong SJ, Ahn CM, Lim DS. Eosinophilic endomyocarditis combined with pericardial and pleural effusion. Korean Circ J. 2009. 39:545–547.

6. Krenke R, Nasilowski J, Korczynski P, et al. Incidence and aetiology of eosinophilic pleural effusion. Eur Respir J. 2009. 34:1111–1117.

7. Martinez-Garcia MA, Cases-Viedma E, Cordero-Rodriguez PJ, et al. Diagnostic utility of eosinophils in the pleural fluid. Eur Respir J. 2000. 15:166–169.

8. Kalomenidis I, Light RW. Eosinophilic pleural effusions. Curr Opin Pulm Med. 2003. 9:254–260.

9. Stein PD, Henry JW. Clinical characteristics of patients with acute pulmonary embolism stratified according to their presenting syndromes. Chest. 1997. 112:974–979.

10. Simon HB, Daggett WM, DeSanctis RW. Hemothorax as a complication of anticoagulant therapy in the presence of pulmonary infarction. JAMA. 1969. 208:1830–1834.

11. Kuwahara T, Hamada M, Inoue Y, Aono S, Hiwada K. Warfarin-induced eosinophilic pleurisy. Intern Med. 1995. 34:794–796.

12. Mo EK, Oh YM, Jung MP, et al. A prospective study on the diagnostic value of adenosine deaminase activity in tuberculous pleural effusion. Korean J Med. 1995. 48:625–633.