Warfarin-Induced Hypoprothrombinemia

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Abstract
HYPERTHYROIDISM has been reported to enhance the anticoagulant response to warfarin sodium.1,2We believe that the following case of increased sensitivity to warfarin was caused primarily by the patient's hyperthyroid state. Report of a Case A 53-year-old diabetic woman was admitted to the City of Memphis Hospitals in March 1974 for right hemiparesis and aphasia that had occurred the day before admission. She had a palpable 3×5-cm nodule in the right lobe of the thyroid. On the first hospital day, the patient went into atrial fibrillation with a rapid ventricular rate for which she was digitalized. Cerebral arteriogram showed occlusion of the posterior parietal branch of the left middle cerebral artery. Heparin sodium therapy was begun on the second hospital day. On the sixth hospital day, warfarin sodium therapy, 7.5 mg daily, was started, and after three days, prothrombin time (PT) increased from 13.7 seconds (control, 11.0) to 35.2

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