Successful Treatment of Severe Gastrointestinal Bleeding Secondary to Crohn Disease with Recombinant Factor VIIa
| Autor: | Israel Oliver-García, Eva Girona, Javier Solís, Venancio Conesa-García, Joaquín Borrás-Blasco, Andrés Navarro-Ruiz, Mariana Fe García-Sepulcre |
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| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty Gastrointestinal bleeding Factor VIIa Gastroenterology Ileocecal valve Crohn Disease Internal medicine medicine Humans Omeprazole biology business.industry Vascular disease General Medicine Factor VII Middle Aged medicine.disease Recombinant Proteins Surgery medicine.anatomical_structure Methylprednisolone Recombinant factor VIIa biology.protein Fresh frozen plasma Gastrointestinal Hemorrhage business Complication medicine.drug |
| Zdroj: | Southern Medical Journal. 100:601-604 |
| ISSN: | 0038-4348 |
| DOI: | 10.1097/smj.0b013e31804859a4 |
| Popis: | A 58-year-old man diagnosed with ileocolonic Crohn disease was admitted to the emergency room with massive lower gastrointestinal hemorrhage and hypovolemic shock. Treatment was started with methylprednisolone, metronidazole and omeprazole. Within the next 24 hours, he received a total of 9 U of red blood cell concentrate and 2 U of fresh frozen plasma. Because of persistence of bleeding, hypovolemic shock and life-threatening situation, we started therapy with rFVIIa. One dose of 120 microg/kg and another dose of 120 microg/kg three hours after the first dose were administered as compassionate use, with resolution of bleeding in the next 12 hours. On day 4 the patient was stabilized. We performed a total colonoscopy and intubation of the ileocecal valve that showed patchy deep ulcerations in the rectum with bleeding inflammatory pseudopolyps. Acute gastrointestinal bleeding is an unusual complication in Crohn disease. In this case, the use of recombinant activated factor VIIa controlled the massive gastrointestinal bleeding secondary to Crohn disease and without clinically significant adverse effect. There are few case reports documenting the use of recombinant activated factor VIIa for this type of off-label indication. Clinical trials should be carried out to define the dosage and dose interval schedule of rFVIIa in the treatment of uncontrolled massive gastrointestinal bleeding secondary to Crohn disease. |
| Databáze: | OpenAIRE |
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