Abstract：
A 36-year-old woman with a history of lupus and antiphospholipid syndrome controlled by warfarin presented to the hospital with left periorbital ecchymosis. She was found to have an INR of 9 despite maintaining her normal warfarin dose of 12.5 mg/15 mg alternating qd. The only identifiable precipitating factor was that the patient recently stopped eating dill pickles. Limiting dietary vitamin K while on warfarin therapy was once considered best practice. However, studies have demonstrated that maintaining a consistent intake of vitamin K is more important than the quantity. Still, many patients on warfarin remain unaware of which foods contain large amounts of vitamin K and are, therefore, susceptible to bleeding sequelae. Practitioners should be educated to inform patients to consume a steady amount of vitamin K in their diet, identify which foods contain vitamin K, and include pickles on that list.
摘要：
一名36岁的妇女，有狼疮和抗磷脂综合征病史，由华法林控制，并出现左眶周瘀斑。尽管维持了12.5mg/15mg交替qd的正常华法林剂量，但仍发现她的INR为9。唯一可识别的诱发因素是患者最近停止吃茴香泡菜。华法林治疗时限制饮食维生素K曾经被认为是最佳做法。然而,研究表明，维持维生素K的持续摄入比维生素K的数量更重要。尽管如此，许多服用华法林的患者仍然不知道哪些食物含有大量的维生素K，因此,容易有出血后遗症.应教育从业者告知患者在饮食中摄入稳定量的维生素K，确定哪些食物含有维生素K，名单上还包括泡菜.
