Bleeding diathesis in amyloidosis with renal insufficiency associated with Crohn's disease: response to desmopressin.
A 53-yr-old man with a 33-yr history of Crohn's ileocolitis, complicated by arthritis and cologastric fistulization, was diagnosed with GI amyloidosis at the time of proctocolectomy. He had marked proteinuria (4.2 g/24 h) and moderate renal insufficiency (BUN of 35 mg/dl and serum creatinine of 2.5 mg/dl). During the operation, he had severe bleeding that required 11 U of blood. Postoperatively, desmopressin was administered, which resulted in a prompt cessation of bleeding. This case demonstrates the efficacy of desmopressin in reversing the bleeding diathesis in surgical patients with amyloidosis complicated by renal insufficiency.
Dave
Sandeep P
SP
Department of Surgery, The Mount Sinai Hospital and The Mount Sinai-NYU Medical Center/Health System, New York, New York 10029, USA.
Greenstein
Adrian J
AJ
Sachar
David B
DB
Harpaz
Noam
N
Aledort
Louis
L
D000686:Amyloidosis / Q000150:complications / Q000473:pathology*; D001803:Blood Transfusion; D003082:Colectomy / Q000009:adverse effects / Q000379:methods; D003424:Crohn Disease / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage*; D004198:Disease Susceptibility / Q000175:diagnosis; D005500:Follow-Up Studies; D006490:Hemostatics / Q000008:administration & dosage; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000175:diagnosis / Q000188:drug therapy*; D051437:Renal Insufficiency / Q000150:complications / Q000473:pathology*; D016896:Treatment Outcome
D006490:Hemostatics; D003894:Deamino Arginine Vasopressin