Myocardial infarction following recombinant activated factor VII in a patient with type 2A von Willebrand disease.
We describe a 50-year-old man with von Willebrand disease type 2A who suffers from angiodysplasia and has required many transfusions for gastro-intestinal haemorrhage. Various investigative modalities have not demonstrated a single source for this. Following a case report of successful use of recombinant activated factor VII (NovoSeven; Novo Nordisk, Copenhagen, Denmark), the patient was treated with it but suffered a large myocardial infarct. As the patient has risk factors for atherosclerotic disease, we presume the recombinant activated factor VII promoted coagulation at a pre-existing atherosclerotic lesion.
Oxford Haemophilia Centre, Thrombosis Unit, Churchill Hospital, Oxford, UK.
Igor Novitzky
IN
Basso
David
D
Keeling
D016888:Angiodysplasia / Q000150:complications*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001803:Blood Transfusion; D023921:Coronary Stenosis / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005167:Factor VII / Q000009:adverse effects*; D005169:Factor VIII / Q000627:therapeutic use; D015942:Factor VIIa; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000150:complications; D007501:Iron / Q000627:therapeutic use; D008297:Male; D008551:Melena / Q000188:drug therapy / Q000209:etiology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000209:etiology; D054328:Proton Pump Inhibitors; D011994:Recombinant Proteins / Q000009:adverse effects*; D014842:von Willebrand Diseases / Q000150:complications* / Q000188:drug therapy
D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D011994:Recombinant Proteins; D005167:Factor VII; D005169:Factor VIII; C103587:recombinant FVIIa; D007501:Iron; D015942:Factor VIIa