{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T11:07:08Z","timestamp":1779016028807,"version":"3.51.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hosp Pharm"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:p>Coumarin derivatives, including warfarin and acenocoumarol, are widely used oral anticoagulants that inhibit vitamin K-dependent coagulation factors. They are commonly prescribed for the prophylaxis of thromboembolic disorders. Although effective, these agents are associated with many adverse drug reactions, which include hemorrhagic complications, warfarin-induced skin necrosis, hypersensitivity reactions, and, rarely, leukocytoclastic vasculitis (LCV). LCV is an immune-mediated small-vessel vasculitis characterised by palpable purpura, often triggered by drugs, infections, or autoimmune conditions. Here, we present the case of a 53-year-old female with a history of rheumatic heart disease and mechanical mitral valve replacement who developed LCV after 5\u2009years on acenocoumarol. The reaction persisted despite adjunct therapy and worsened upon switching to warfarin, suggesting possible cross-reactivity between these coumarin derivatives. Ultimately, transitioning to apixaban led to the complete resolution of symptoms. This case underscores the importance of early recognition of drug-induced vasculitis and highlights the need for individualised anticoagulation strategies in patients with hypersensitivity reactions.<\/jats:p>","DOI":"10.1177\/00185787251396799","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T11:40:19Z","timestamp":1766749219000},"page":"228-233","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Leukocytoclastic Vasculitis Associated with Coumarin Derivatives: A Case Report"],"prefix":"10.1177","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8710-2397","authenticated-orcid":false,"given":"Manjappa","family":"Mahadevappa","sequence":"first","affiliation":[{"name":"Department of Cardiology, JSS Medical College &amp; Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4708-9868","authenticated-orcid":false,"given":"Himabindu","family":"Jayaprakash Narayan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysore, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7792-8576","authenticated-orcid":false,"given":"Bharath Raj","family":"Srinivasan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysore, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4429-7232","authenticated-orcid":false,"given":"Namratha","family":"Ravishankar","sequence":"additional","affiliation":[{"name":"Department of Pathology, JSS Medical college &amp; Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,26]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(00)01135-9"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/EURHEARTJ\/SUAB153"},{"key":"e_1_3_2_4_2","unstructured":"Amaraneni A Chippa V Goldin J Rettew AC. Anticoagulation Safety. StatPearls. Published online October 6 2024. Accessed December 29 2024. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK519025\/"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.4103\/2249-4863.184643"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11739-021-02688-x"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780330808"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.7759\/CUREUS.50885"},{"key":"e_1_3_2_9_2","unstructured":"View of drug-induced leukocytoclastic vasculitis: tigecycline a rare cause. SW Respir Crit Care Chron. 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