Modulation of hemostatic balance with antithrombin III replacement therapy in a case of liver cirrhosis associated with recurrent venous thrombosis.
Patients with liver failure can present both thrombotic and hemorrhagic complications because of the deficiency in coagulation factors and inhibitors (protein C and S, antithrombin III) and impairment of fibrinolytic balance. Here we report the case of a 63-year-old man with liver cirrhosis, recurrent thrombosis, and features of low-grade consumption coagulopathy, showing severe antithrombin III deficiency (about 30% of normal values). Treatment with antithrombin III (2000 U/day) and low doses of heparin (5000 U b.i.d.) was successful in modulating the coagulation system toward an antithrombotic effect. After discharge from hospital the ambulatory treatment with antithrombin III concentrates (2000 U twice a week) allowed the attainment of antithrombin III activity of about 60% and prevented the patient from recurrence of venous thrombosis.
Carmassi
F
F
Istituto di Clinica Medica II, Università di Pisa, Italy.
Morale
M
M
De Negri
F
F
Carrai
M
M
D000990:Antithrombin III / Q000627:therapeutic use*; D020152:Antithrombin III Deficiency; D004211:Disseminated Intravascular Coagulation / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006487:Hemostasis / Q000187:drug effects; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D013924:Thrombophlebitis / Q000150:complications* / Q000188:drug therapy
D000990:Antithrombin III; D006493:Heparin