Abstract：A 55-year-old male patient with severe mitral valve insufficiency received long-time warfarin anticoagulation therapy after mechanical mitral valve replacement and the international standard ratio (INR) was 2.00-3.00. Because of oral ulcers, he took the water soaked with dandelion (Taraxacum mongolicum Hand-Mass.), which was self-purchased and sun-dried, for daily drinking. Fifteen days later, the patient developed chest tightness, shortness of breath, palpitation, and fatigue, followed by nausea, vomiting, mild edema of the lower limbs, orthopnea at night, ecchymosis on the right lower limb, and black stool successively. Laboratory tests showed hemoglobin 52-g/L, red blood cell count 2.05×1012/L. Gastrointestinal bleeding was considered, which might be related to the water soaked with dandelion drunk during warfarin therapy. Warfarin and water soaked with dandelion were stopped. The patient received symptomatic treatments including IV infusions of leukocyte-depleted red blood cell suspension 2 units (2 times in total) and esomeprazole 80-mg (twice daily), an intramuscular injection of vitamin K1-10-mg, and oral vitamin K1-20-mg. Two days later, the patient′s INR was 1.58, hemoglobin was 84-g/L, and red blood cell count was 2.33×1012/L. Five days later, his INR was 1.63, hemoglobin was 104-g/L, and red blood cell count was 3.92×1012/L.
王丽岩，陈艳伟，栗云明. 服用华法林期间饮用蒲公英水致消化道出血[J]. 药物不良反应杂志, 2020, 22(11): 650-651.
Wang Liyan, Chen Yanwei, Li Yunming. Gastrointestinal bleeding caused by drinking water soaked with dandelion during warfarin administration. Adverse Drug Reactions Journal, 2020, 22(11): 650-651.
