Document Detail


Hirudin treatment for multiple thromboses in a preterm infant with inherited thrombophilia.
MedLine Citation:
PMID:  17473583     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Thromboembolic events in preterm infants constitute a serious problem in neonatal intensive care. In most cases, treatment with low-molecular-weight heparin offers a sufficient therapy of thrombotic events. We report the case of a severely sick male preterm infant with a heterozygous factor V Leiden mutation and protein C deficiency. The infant developed multiple thromboses despite adequate anticoagulation with enoxaparin and was in a life-threatening situation. Treatment with hirudin prevented the occurrence of new thromboses without causing bleeding complications. After 2 weeks hirudin was discontinued and low-molecular-weight heparin therapy was started again. A successive recanalization of the vast majority of affected vessels was observed within the following 6 months. Despite some minor neurologic sequelae and a slight delay in neuro-motor development, the 2.5-year-old boy is in a healthy condition. This case demonstrates that hirudin can be an effective alternative anticoagulant in neonates and infants refractory to heparin treatment. Efficacy and safety issues of hirudin treatment, however, need to be evaluated in randomized trials.
Authors:
Alexander Sturm; Christian P Speer; Johannes Wirbelauer; Ralf Grossmann
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis     Volume:  18     ISSN:  0957-5235     ISO Abbreviation:  Blood Coagul. Fibrinolysis     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-02     Completed Date:  2007-07-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102551     Medline TA:  Blood Coagul Fibrinolysis     Country:  England    
Other Details:
Languages:  eng     Pagination:  381-3     Citation Subset:  IM    
Affiliation:
University Children's Hospital, Wuerzburg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Activated Protein C Resistance / complications,  drug therapy*
Factor V / genetics,  physiology*
Fibrinolytic Agents / therapeutic use*
Hirudin Therapy*
Humans
Infant
Infant, Newborn
Infant, Premature*
Male
Phlebography
Protein C Deficiency / complications,  drug therapy*,  genetics
Thrombosis / drug therapy*
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; 0/factor V Leiden; 9001-24-5/Factor V

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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