[Resistance to acenocoumarol revealing a missense mutation of the vitamin K epoxyde reductase VKORC1: a case report]

M C Mboup; K Dia; D M Ba; P D Fall

doi:10.1016/j.ancard.2013.08.018

[Resistance to acenocoumarol revealing a missense mutation of the vitamin K epoxyde reductase VKORC1: a case report]

Ann Cardiol Angeiol (Paris). 2015 Feb;64(1):59-61. doi: 10.1016/j.ancard.2013.08.018. Epub 2013 Sep 10.

[Article in French]

Authors

M C Mboup¹, K Dia², D M Ba², P D Fall²

Affiliations

¹ Service de cardiologie, hôpital principal de Dakar, 1, avenue Nelson Mandéla, BP 3006, Dakar, Sénégal. Electronic address: mcmboup@yahoo.fr.
² Service de cardiologie, hôpital principal de Dakar, 1, avenue Nelson Mandéla, BP 3006, Dakar, Sénégal.

PMID: 24095214
DOI: 10.1016/j.ancard.2013.08.018

Abstract

A significant proportion of the interindividual variability of the response to vitamin K antagonist (VKA) treatment has been associated with genetic factors. Genetic variations affecting the vitamin K epoxide reductase complex subunit 1 (VKORC1) are associated with hypersensitivity or rarely with resistance to VKA. We report the case of a black women patient who presents a resistance to acenocoumarol. Despite the use of high doses of acenocoumarol (114 mg/week) for the treatment of recurrent pulmonary embolism, the International Normalized Ratio was below the therapeutic target. This resistance to acenocoumarol was confirmed by the identification of a missense mutation Val66Met of the vitamin K epoxide reductase.

Keywords: Mutation Val66Met vitamin K epoxide reductase; Mutation Val66Met vitamine K époxyde réductase; Resistance to acenocoumarol; Résistance acénocoumarol.

Publication types

Case Reports

MeSH terms

Acenocoumarol / therapeutic use*
Adult
Anticoagulants / therapeutic use*
Drug Resistance / genetics*
Female
Humans
Mutation, Missense*
Pulmonary Embolism / drug therapy*
Vitamin K Epoxide Reductases / genetics*

Substances

Anticoagulants
VKORC1 protein, human
Vitamin K Epoxide Reductases
Acenocoumarol