title: [The use of urokinase and ammonium chloride in unblocking a central venous catheter in a child with acute lymphoblastic leukemia].
abstract: Central venous catheter (C.V.C.) mechanical obstruction in immunocompromised patients can yield several complications sometime life-threatening and can be promptly solved by thrombolytic treatment. The authors describe a case of a child affected by acute lymphoblastic leukemia and experiencing an obstruction of his C.V.C. very difficult to treat with conventional urokinase treatment. Thinking the lack of success to be attributed to a calcium thrombus, the Authors before pulling out the C.V.C., made use of ammonium chloride solution in order to obtain the disappearance of the little bag covering the tip of C.V.C. The treatment was successful as confirmed by the contrast medium examination and the use of C.V.C. lasted for several months without other mechanical obstruction. In our best knowledge this is one of the first attempts with such ammonium chloride solution which have been used successful and rather safely. The only drug induced symptoms were constituted by mild and transient vomiting. Owing to this positive experience the authors believe useful to confirm this treatment in other cases. In this contest an experienced hematoncology team must take care of C.V.C. related complications.
authors.affiliation: Clinica Pediatrica dell'Università di Milano, Ospedale San Gerardo dei Tintori, Monza, Italia.
authors.forename: A
authors.initials: A
authors.lastname: Piroddi
authors.forename: G
authors.initials: G
authors.lastname: Favini
authors.forename: D
authors.initials: D
authors.lastname: Fraschini
authors.forename: C
authors.initials: C
authors.lastname: Pezzini
authors.forename: A
authors.initials: A
authors.lastname: Locasciulli
authors.forename: C
authors.initials: C
authors.lastname: Uderzo
mesh_terms: D000643:Ammonium Chloride / Q000008:administration & dosage*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002648:Child; D003131:Combined Modality Therapy; D004868:Equipment Failure; D006801:Humans; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D011859:Radiography; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage*; D014683:Vena Cava, Superior / Q000000981:diagnostic imaging
chemical_list: D000643:Ammonium Chloride; D014568:Urokinase-Type Plasminogen Activator
vernacular_title: Uso dell'urokinasi e del cloruro d'ammonio nella disostruzione di un catetere venoso centrale in un bambino con leucemia linfoblastica acuta.