Phlegmasia cerulea dolens associated with acute coronavirus disease 2019 pneumonia despite supratherapeutic warfarin anticoagulation

Tristen T. Chun, MD; Juan Carlos Jimenez, MD, MBA; Joe L. Pantoja, MD; John M. Moriarty, MD; Shanna Freeman, NP

Journal of Vascular Surgery Cases and Innovative Techniques (Dec 2020)

Phlegmasia cerulea dolens associated with acute coronavirus disease 2019 pneumonia despite supratherapeutic warfarin anticoagulation

Tristen T. Chun, MD,
Juan Carlos Jimenez, MD, MBA,
Joe L. Pantoja, MD,
John M. Moriarty, MD,
Shanna Freeman, NP

Affiliations

Tristen T. Chun, MD: Department of Vascular Surgery, Gonda (Goldschmied) Vascular Center, David Geffen School of Medicine at UCLA, Los Angeles, Calif
Juan Carlos Jimenez, MD, MBA: Department of Vascular Surgery, Gonda (Goldschmied) Vascular Center, David Geffen School of Medicine at UCLA, Los Angeles, Calif; Correspondence: Juan Carlos Jimenez, MD, MBA, Department of Vascular Surgery, Gonda (Goldschmied) Vascular Center, David Geffen School of Medicine at UCLA, 200 Medical Plaza, Ste 526, Los Angeles, CA 90095
Joe L. Pantoja, MD: Department of Vascular Surgery, Gonda (Goldschmied) Vascular Center, David Geffen School of Medicine at UCLA, Los Angeles, Calif
John M. Moriarty, MD: Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, Calif
Shanna Freeman, NP: Department of Vascular Surgery, Gonda (Goldschmied) Vascular Center, David Geffen School of Medicine at UCLA, Los Angeles, Calif

Journal volume & issue: Vol. 6, no. 4
pp. 653 – 656

Abstract

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Patients with acute coronavirus disease 2019 (COVID-19) respiratory infection are associated with concomitant thromboembolic complications and a hypercoagulable state. Although these mechanisms are not completely understood, unique alterations in the serum markers for hemostasis and thrombosis have been detected. A high index of suspicion is required by vascular surgeons for patients presenting with this novel virus. We present the case of a 51-year-old man with acute COVID-19 pneumonia who developed phlegmasia cerulea dolens despite chronic warfarin therapy and a supratherapeutic international normalized ratio.

Published in Journal of Vascular Surgery Cases and Innovative Techniques

ISSN: 2468-4287 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Surgery; Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.sciencedirect.com/journal/journal-of-vascular-surgery-cases-innovations-and-techniques

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