Document Detail


Reversal of low-molecular-weight heparin-induced bleeding in patients with pre-existing hypercoagulable states with human recombinant activated factor VII concentrate.
MedLine Citation:
PMID:  16823826     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Low-molecular-weight heparins are widely employed in prophylactic and therapeutic antithrombotic regimens for venous thromboembolic events. Excessive anticoagulation with low-molecular-weight heparins rarely can precipitate catastrophic bleeding complications. Currently, there is no specific or reliable antidote that can reverse the anticoagulant effects of low-molecular-weight heparins efficiently and safely. This report describes three individuals with underlying hypercoagulable states, who developed clinically significant bleeding complications while receiving therapeutic anticoagulation with enoxaparin. All of the hemorrhagic events subsequently were safely and effectively reversed with a single intravenous bolus infusion of recombinant activated factor VIIa (RFVIIa) concentrate. Hemoglobins, prothrombin times, and clinical overt bleeding were monitored before and after the administration of RFVIIa. In all three cases, bleeding was controlled without an increase in thrombotic events. Our findings demonstrate that RFVIIa can rapidly and safely reverse the hemorrhagic adverse effects associated with excessive levels of low-molecular-weight heparin in patients with pre-existing hypercoagulable conditions and/or acute venous thromboembolism.
Authors:
Kashif Firozvi; Ruby Anne E Deveras; Craig M Kessler
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  American journal of hematology     Volume:  81     ISSN:  0361-8609     ISO Abbreviation:  Am. J. Hematol.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-14     Completed Date:  2007-10-09     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7610369     Medline TA:  Am J Hematol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  582-9     Citation Subset:  IM    
Affiliation:
Division of Hematology/Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA. firozvik@gunet.georgetown.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Drug Toxicity
Factor VII / therapeutic use*
Factor VIIa
Female
Hemorrhage / chemically induced*,  drug therapy*,  etiology
Heparin / administration & dosage,  adverse effects*
Humans
Injections, Intravenous
Male
Middle Aged
Molecular Weight
Recombinant Proteins / therapeutic use
Risk Factors
Thrombophilia / blood,  complications*,  drug therapy*,  etiology
Treatment Outcome
Chemical
Reg. No./Substance:
0/Recombinant Proteins; 0/recombinant FVIIa; 9001-25-6/Factor VII; 9005-49-6/Heparin; EC 3.4.21.21/Factor VIIa

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


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