Can treatment with warfarin cause leucopenia?/nA 50-year-old man, resistant for APC (Activated prot

Fråga: Can treatment with warfarin cause leucopenia?<br><br>A 50-year-old man, resistant for APC (Activated protein C), is treated with warfarin since long due to several deep venous thrombosis and a concomitant pulmonary embolism. In January 1997, a decreased level of leucocytes (2.3 x 10(9)/l, normal range 4-9 x 10(9)/l) was found (in July, 1996 the level was 4.8 x 10(9)/l). A month later, February 27, the level of leucocytes was further decreased to 1.0 x 10(9)/l. Count of red blood cells and thrombocytes was normal, 141 g/l (normal range 134-166 g/l) and 162 x 10(9)/l (normal range 150-400 x 10(9) g/l) respectively.<br><br>The patient is not on other drugs.

Sammanfattning: There is no evidence that warfarin may cause leucopenia.

Svar: The question concerning leucopenia during treatment with warfarin has been raised before (1,2). No documentation in the literature could be found that confirms such a connection. An updated search in the literature, Medline, Drugline and SADRAC (Swedish Adverse Drug Reaction Advisory Committee) has not revealed any further information on leucopenia during treatment with warfarin.<br><br>The manufacturer (3) confirms that no documentation exists concerning warfarin and leucopenia. However, WHO has received 19 reports of leucopenia in connection to warfarin treatment, but the causal relationship could not be specified.<div id="referenser" style="display:none;">1 Drugline nr 07118 (year 1989) (enclosed)<br>2 Drugline nr 09166 (year 1992) (enclosed)<br>3 Personal communication Nils Olof Johansson, Nycomed</div>