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KMID : 0191120070220030557
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Journal of Korean Medical Science
2007 Volume.22 No. 3 p.557 ~ p.559
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A Case Report of a Patient Carrying CYP2C9*3/4 Genotype with Extremely Low Warfarin Dose Requirement
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Lee Soo-Youn
Nam Myung-Hyun
Kim June-Soo
Kim Jong-Won
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Abstract
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We report a case of intolerance to warfarin dosing due to impaired drug metabolism in a patient with CYP2C9*3/*4. A 73-yr-old woman with atrial fibrilation was taking warfarin. She attained a high prothrombin time international normalized ratio (INR) at the standard doses during the induction of anticoagulation and extremely low dose of warfarin (6.5 mg/week) was finally chosen to reach the target INR. Genotyping for CYP2C9 revealed that this patient had a genotype CYP2C9*3/*4. This is the first Korean compound heterozygote for CYP2C9*3 and *4. This case suggests the clinical usefulness of pharmacogenetic testing for individualized dosage adjustments of warfarin.
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KEYWORD
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Warfarin, Cytochrome P-450 CYP2C9, Polymorphism, Prothrombin Time, Pharmacogenetics
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