Recombinant activated factor VII combined with local measures in preventing bleeding from invasive dental procedures in patients with Glanzmann thrombasthenia.
Recombinant activated factor VII (rFVIIa), combined with local measures of fibrin glue and a celluloid splint, preventing bleeding from four invasive dental procedures is reported. A single dose of 180-200 micro g/kg was successfully used in three surgical removals of impacted teeth. Four doses of rFVIIa were required in another full mouth treatment of extraction, pulpotomy, filling and the stainless steel crowning of 13 teeth. The repeated dose of rFVIIa was given whenever the bleeding complication was visualized. It is cost-effective for preventing external bleeding. Additionally, an oral rinsing solution of tranexamic acid (25 mg/kg) was given three times a day for 7 days. In conclusion, rFVIIa has been shown to be an effective alternative to platelet concentrate in patients with Glanzmann thrombasthenia.
Chuansumrit
Ampaiwan
A
Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. raajs@mahidol.ac.th
Suwannuraks
Monthon
M
Sri-Udomporn
Nantana
N
Pongtanakul
Bunchoo
B
Worapongpaiboon
Surapon
S
D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001792:Blood Platelets / Q000187:drug effects / Q000378:metabolism; D002648:Child; D004305:Dose-Response Relationship, Drug; D005167:Factor VII / Q000627:therapeutic use*; D015942:Factor VIIa; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D006801:Humans; D008297:Male; D006472:Oral Hemorrhage / Q000188:drug therapy*; D010974:Platelet Aggregation / Q000187:drug effects; D011994:Recombinant Proteins / Q000627:therapeutic use*; D013915:Thrombasthenia / Q000097:blood / Q000188:drug therapy* / Q000601:surgery; D014081:Tooth Extraction / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome
D015718:Fibrin Tissue Adhesive; D011994:Recombinant Proteins; D005167:Factor VII; C103587:recombinant FVIIa; D015942:Factor VIIa