Acenocoumarol
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Acenocoumarol Leucocytoclastic vasculitis: case report A 61-year-old man with auricular fibrillation developed leucocytoclastic vasculitis during anticoagulant therapy with acenocoumarol. The man was admitted for treatment of Fournier’s gangrene; 3 days earlier, he was diagnosed with auricular fibrillation and started receiving anticoagulation therapy with acenocoumarol [dosage not stated]; his medical history included diabetes mellitus, ischaemic cardiopathy treated with aspirin and carvedilol, hypercholesterolaemia treated with simvastatin, and chronic renal failure due to nephroangiosclerosis (creatinine clearance 18 mL/min). Four days after acenocoumarol was initiated, he developed oedema symptoms in his ankles, as well as pruritic palpable purpura which most affected his lower extremities but also his arms, face, soles of feet and palms. Laboratory investigations showed a prothrombin time of 47% [sic] with worsening of renal function (creatinine clearance 15 mL/min). Acenocoumarol was discontinued, and low molecular weight heparin was initiated. The man had progressive improvement in his symptoms. Serology tests for hepatotropic viruses, antinuclear antibodies, rheumatoid factor and complement determination were all negative. At last followup, he was free of symptoms receiving a low molecular weight heparin at an anticoagulant dose. Vizoso MDR, et al. Leukocytoclastic vasculitis and acenocoumarol. Medicina Clinica 130: 399, No. 10, 22 Mar 2008 [Spanish; summarised from a translation] 801080971 Spain
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Reactions 5 Jul 2008 No. 1209
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