Methods-Results
A 43-year-old man presented with dyspnea, hemoptisis and chest pain. The final diagnosis was acute pulmonary thromboembolism following acute deep venous thrombosis(DVT). He was treated with low molecular weight heparin (LMWH) and warfarin. The eosinophil count was normal before initiation of warfarin. However the eosinophil ratio gradually increased to 10% (800/mm 3 ) in the first week. The examination for ova and parasites was negative. Blood biochemistry and several kinds of allergen tests were normal. IgE level was slightly increased. The INR value of the patient increased very quickly and daily need was 1.25 mg to stabilize INR between 2-3. With 8.75 mg/week dosing, the eosinophil count was stabilized at 600/mm 3 . The patient was heterozygos for factor V Leiden and he was experiencing a second attack of DVT. Therefore he had a lifelong oral anticoagulation (OAC) therapy indication. A second 55-year-old male patient presented with rapid ventricular response lone atrial fibrillation(AF). During discharge 27.5 mg/week warfarin was started. On his first control 10 days later,the INR was 17. He was hospitalized to receive vitamin K and fresh frozen plasma. Hemogram before AF attack was normal, but when he was hospitalized for warfarin overdose he had 10% (appr. 800/mm 3 ) eosinophils in the peripheral blood. Allergy and parasites tests were negative. He was not on any medications other than warfarin. During discharge we started 20mg/day rivaroxaban and 25 mg carvediolol. The eosinophil count decreased to 400/mm 3 one month after cessation of warfarin.
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