Ten-year experience with acenocoumarol treatment in an ambulatory cohort of Spanish patients.

OBJECTIVE: To analyse incidence of hemorrhagic and thrombotic events in a series of ambulatory patients receiving acenocoumarol in a rural area of Spain (1997-2007). RESULTS: Out of 1,544 patients, 1,086 are receiving acenocoumarol at present (2% of our region's population). The total follow-up was 5,462 patients-years. Median age was 74 years. INR therapeutic range was 2.0-3.0 in 82.5%. Atrial fibrillation (AF) was the most frequent indication (73%). Incidence of hemorrhagic and thrombotic events was 2.27 and 0.2/100 patients-year, respectively. Gastrointestinal tract was the most frequent site of bleeding. In multivariate analysis, patients with AF and prosthetic heart valves (PHV) had increased risk of bleeding (OR 2.1 and 4.8, respectively). Age and therapeutic ranges of INR were not associated with increased risk of bleeding. CONCLUSIONS: 2% of our population is receiving acenocoumarol. Incidence of hemorrhagic and thrombotic events was low. Patients with AF and PHV had increased risk of bleeding.

[Organizing pneumonia associated with the use of pegylated interferon alfa]. / Neumonía organizada asociada a tratamiento con peginterferón alfa.

Organizing pneumonia is a well-differentiated clinical and histologic entity whose onset is usually subacute with respiratory symptoms and pulmonary infiltrates. Its origin may be unknown (cryptogenic) or it may be associated with various medical conditions, infectious diseases, or drugs. Diagnosis is confirmed by the presence of foci of organizing pneumonia in lung biopsy specimens. Our patient was a 49-year-old man infected with the hepatitis C virus who was receiving pegylated interferon alfa-2b. He presented with dry cough, fever, dyspnea, and ground glass pulmonary infiltrates. After an open lung biopsy, he was diagnosed with organizing pneumonia. When pegylated interferon was discontinued and corticosteroids started, the symptoms and pulmonary infiltrates disappeared. To our knowledge, this is the second report of organizing pneumonia related to pegylated interferon alfa-2b.

Neumonía organizada asociada a tratamiento con peginterferón alfa / Organizing pneumonia associated with the use of pegylated interferon alfa

La neumonía organizada es una entidad clínico-histológica bien diferenciada, que suele presentarse de forma subaguda con síntomas respiratorios e infiltrados pulmonares. Puede ser de causa desconocida (criptogenética) o estar asociada a distintas enfermedades, infecciones o fármacos. El diagnóstico de seguridad requiere la demostración de focos de neumonía organizada en muestras de biopsia pulmonar. Presentamos el caso de un paciente de 49 años con infección por el virus de la hepatitis C en tratamiento con peginterferón a-2b que desarrolló un cuadro de tos seca, fiebre, disnea e infiltrados pulmonares en vidrio deslustrado, y a quien se diagnosticó por biopsia pulmonar abierta de neumonía organizada. Con la retirada del peginterferón y tratamiento con corticoides desaparecieron los síntomas y los infiltrados pulmonares. En nuestro conocimiento, éste es el segundo caso comunicado de neumonía organizada en relación con peginterferón afa-2b (AU)

Organizing pneumonia is a well-differentiated clinical and histologic entity whose onset is usually subacute with respiratory symptoms and pulmonary infiltrates. Its origin may be unknown (cryptogenic) or it may be associated with various medical conditions, infectious diseases, or drugs. Diagnosis is confirmed by the presence of foci of organizing pneumonia in lung biopsy specimens. Our patient was a 49-year-old man infected with the hepatitis C virus who was receiving pegylated interferon alfa-2b. He presented with dry cough, fever, dyspnea, and ground glass pulmonary infiltrates. After an open lung biopsy, he was diagnosed with organizing pneumonia. When pegylated interferon was discontinued and corticosteroids started, the symptoms and pulmonary infiltrates disappeared. To our knowledge, this is the second report of organizing pneumonia related to pegylated interferon alfa-2b (AU)