question-icon

What causes swollen legs while on Warfarin?

default
Posted on Fri, 18 Sep 2015
Question: Hi! Thanks for answering my previous questions!
My INR seems to be jumping around. I had Cerebral Venous sinus thrombosis (in jugular vein) - clot has broken down finally. I'm still on warfarin. Testing will begin with regards to cause of clot. I'm 37 years old.
I have Crohn's disease. My legs often swell and my stomach often is distended. My legs have red patches and after itchy skin after a shower but it stops. I've been told it isn't symptoms of Crohns. I'm confused what it may be attributed to. I have often been active - but now I keep getting fatigued.
doctor
Answered by Dr. Shailja Puri (27 minutes later)
Brief Answer:
INR to be monitored,doppler of legs & clinical assessment of red patches

Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.

Since, you are on warfarin, you need to get your INR monitored regularly.
The INR should be below 2.5 till the time you are on medication.
In case it goes above 2.5 you need to consult your treating doctor regarding dose adjustment.
Secondly, the swelling in the legs need to be investigated.
Since, you have a history of cerebral venous sinus thrombosis, there is a possibility of deep venous thrombosis (DVT) in legs.
DVT may be associated with pain and swelling of legs.
Doppler studies will be helpful to detect any clot if present.
Thirdly, the red and itchy patches on legs are unlikely to be due to crohns disease.
Increase in itchiness after shower could be due to some primary skin lesion or it could be due to blood vessel disorder (vasculitis).
Vasculitis is inflammation of the vessel wall and it can be auto-immune in nature.
I suggest you to consult your physician for clinical assessment, relevant investigations and thus management.

Thanks and take care
Dr Shailja Puri



Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
default
Follow up: Dr. Shailja Puri (5 hours later)
Hi there - thank you for your response. My INR has been unstable. It has gone from 1.6 and this week to 3.1. The leg swelling / red patches has been brought to my doc's notice. However not much has been done since my stroke. Which blood test / trst should i request for? I have attached photo of my lef that has red patch. Thanks.
doctor
Answered by Dr. Shailja Puri (1 hour later)
Brief Answer:
Doppler of legs and dermatological consultation will be helpful.

Detailed Answer:
Hello and welcome again,
You need to consult your treating doctor for possible change in warfarin dosage due to varying fluctuating INR.
A doppler of legs will be beneficial to rule out DVT.
For the red patches, you need to consult a dermatologist for clinical assessment and investigations like biopsy for diagnosis.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Shailja Puri

Pathologist and Microbiologist

Practicing since :2006

Answered : 8144 Questions

premium_optimized

The User accepted the expert's answer

Share on
What causes swollen legs while on Warfarin?

Brief Answer: INR to be monitored,doppler of legs & clinical assessment of red patches Detailed Answer: Hello, Thanks for posting your query on HealthcareMagic. Since, you are on warfarin, you need to get your INR monitored regularly. The INR should be below 2.5 till the time you are on medication. In case it goes above 2.5 you need to consult your treating doctor regarding dose adjustment. Secondly, the swelling in the legs need to be investigated. Since, you have a history of cerebral venous sinus thrombosis, there is a possibility of deep venous thrombosis (DVT) in legs. DVT may be associated with pain and swelling of legs. Doppler studies will be helpful to detect any clot if present. Thirdly, the red and itchy patches on legs are unlikely to be due to crohns disease. Increase in itchiness after shower could be due to some primary skin lesion or it could be due to blood vessel disorder (vasculitis). Vasculitis is inflammation of the vessel wall and it can be auto-immune in nature. I suggest you to consult your physician for clinical assessment, relevant investigations and thus management. Thanks and take care Dr Shailja Puri