Permission for Use

Surreptitious Coumadin Ingestion

Lab Studies

March 14

Urinalysis - many RBCs
ANA titer - positive
Chemistry Profile - remarkable for a : Total Protein - 5.4 g/dl
Albumin - 2.2 g/dl
Calcium - 6.2 mg/dl
Glucose - 325 mg/dl
Alk Phos - 275 mU/ml
AST - 50 mU/ml

24 hour urine for protein elevated at 1,400 mg

WBC - 6,900
Hgb - 13.6 gm
Hct - 38%
Normal peripheral smear and differential IgE elevated
Eosinophilia

Factor VIII 128% of normal
Factor V 100% of normal
Factor VII 30% of normal
Factor X 5% of normal
Factor IX 15% of normal
Factor II 5% of normal

What do the above laboratory studies indicate?

What would you recommend for treatment?

March 20

PT - 22.5 sec
APTT - 49.6 sec
FDP - > 10 < 40 mg/ml
I - 512 mg/dl

What would be your final diagnosis?