CASO CLINICO   

La Rivista Italiana della Medicina di Laboratorio 2020 Dicembre;16(4):305-8

DOI: 10.23736/S1825-859X.20.00080-8

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: Italian

Suspected interaction of Ganoderma lucidum on warfarin therapy in hemodialysis patient

Massimiliano L. MANNO ¹ ✉, Anna M. MONTINARO ²

¹ Servizio di Medicina di Laboratorio, Città di Lecce Hospital - GVM Care and Research, Lecce, Italia; ² Servizio di Emodialisi, Città di Lecce Hospital - GVM Care and Research, Lecce, Italia

Some drugs and medicinal plants interfere with warfarin affecting platelet aggregation and blood coagulation. Ganoderma lucidum (commonly known as Lingzhi, Ruishi or Shenzhi, or also as “mushroom of immortality”) is a medical mushroom, and its extracts are used in traditional Chinese medicine and also marketed on-line, in order to prevent or treat a large variety of diseases. Several studies had demonstrated that Ganoderma lucidum can compromise hemostasis because of its antithrombotic and anticoagulant activity. Here we report the case of a 41-year-old-man, with history of heart disease and hypertension, on hemodialysis since 2017, who had been receiving ongoing anticoagulant therapy with warfarin. We reported two consecutive increased INR value, respectively 6.92 and 8.22, confirmed by two different instruments and blood drawn repeating. Anamnesis revealed a recent ingestion of two 500 mg tablets of Ganoderma lucidum extracts, just in these two circumstances. The previous and subsequent INR values were always in-range. A correlation between increased INR values and Ganoderma lucidum tablet ingestion was suspected.

KEY WORDS: Ganoderma; Hemostasis; Blood coagulation; Warfarin