Carbon tetrachloride exposure during anticoagulant therapy. Dangerous enhancement of hypoprothrombinemic effect

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Abstract
IT IS generally known that caution is necessary in the initiation of anticoagulant therapy in patients who are known to have kidney or liver dysfunction. The purpose of this report is to add the caution that anyone on a regimen of anticoagulant therapy should assiduously avoid exposure to carbon tetrachloride and other hepatotoxic and nephrotoxic drugs. That minimal exposure to carbon tetrachloride which might not produce apparent illness in others can lead to serious hypoprothrombinemia in patients on a regimen of anticoagulants is indicated by events in the experience that is described. Report of a Case The 59-year-old white man was admitted to the hospital on April 20, 1965. He had been treated for arteriosclerotic heart disease and angina pectoris since the age of 37, when he had the first of several known heart attacks. He had been taking bishydroxycoumarin (Dicumarol) since his last known infarction in 1960. During this

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