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   intelligent diagnosis, unexpected complication in a munchausen case of warfarin abuse  
   
نویسنده daraie morteza ,allameh farshad ,abbaszadeh mahsa
منبع case reports in clinical practice - 2017 - دوره : 2 - شماره : 2 - صفحه:50 -54
چکیده    a 25-year-old man with 10 years history of a migraine headache noticed ecchymotic lesions involving anterior chest wall, both upper and lower limbs that were unrelated to trauma. his laboratory data revealed prothrombin time (pt) 32 seconds, partial thromboplastin time (ptt) 44 seconds, international normalized ratio 6, and normal bleeding time. mixing study was performed and normalized pt to 13 seconds and ptt to 38 seconds. factor activity assay revealed a low level of factors ii, vii, ix, and x but normal level of factor v. factitious disorders were in high priority in our differential diagnosis. thus, we evaluated serum warfarin level which was positive. there were no doubts that we encountered munchausen case that abused warfarin compounds. we decided to use factor eight inhibitor bypassing activity for rapid correction of coagulation disorder. he suddenly complained of chest pain and dyspnea. we encountered to pulmonary embolism.
کلیدواژه munchausen syndrome ,blood coagulation ,pulmonary embolism
آدرس tehran university of medical sciences, imam khomeini hospital, school of medicine, department of internal medicine, ایران, tehran university of medical sciences, imam khomeini hospital, school of medicine, department of internal medicine, ایران, tehran university of medical sciences, imam khomeini hospital, school of medicine, department of internal medicine, ایران
پست الکترونیکی mahsa.abbaszadeh@yahoo.com
 
 

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