title: A cerebrovascular event after single-dose administration of recombinant factor VIIa in a patient with esophageal variceal bleeding.
abstract: Upper gastrointestinal bleeding (UGIB) is a life-threatening complication of cirrhosis that develops from esophageal varices in almost 70% of patients. The mortality rate from the bleeding episodes is reported to be 30% [1-4]. Standard management of UGIB of cirrhotic patients is vasoactive therapy combined with endoscopic procedures such as endoscopic sclerotherapy and band ligation [5]. Currently, it is reported that recombinant activated fVIIa (Novoseven, NovoNordisc) can correct the prothrombin time in decompensated cirrhotic patients and also can be used safely in Child's B and C cirrhotic patients with UGIB [6-8]. Herein, we describe the first case report in the literature of a cerebrovascular event after the administration of a single dose of fVIIa in a cirrhotic patient with esophageal variceal bleeding.
authors.affiliation: The Department of Gastroenterology, Ege University Medical School, Bornova, 35040 Izmir, Turkey. akyildizmr@yahoo.com
authors.forename: Murat
authors.initials: M
authors.lastname: Akyildiz
authors.forename: Ilker
authors.initials: I
authors.lastname: Turan
authors.forename: Omer
authors.initials: O
authors.lastname: Ozutemiz
authors.forename: Yucel
authors.initials: Y
authors.lastname: Batur
authors.forename: Tankut
authors.initials: T
authors.lastname: Ilter
mesh_terms: D000328:Adult; D017707:Erythrocyte Transfusion; D004932:Esophageal and Gastric Varices / Q000097:blood / Q000150:complications* / Q000628:therapy; D004945:Esophagoscopy; D005167:Factor VII / Q000009:adverse effects*; D015942:Factor VIIa; D017809:Fatal Outcome; D006471:Gastrointestinal Hemorrhage / Q000097:blood / Q000209:etiology* / Q000628:therapy; D006501:Hepatic Encephalopathy / Q000097:blood / Q000209:etiology / Q000401:mortality; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000628:therapy; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications / Q000628:therapy; D008111:Liver Function Tests; D008297:Male; D011994:Recombinant Proteins / Q000009:adverse effects; D015911:Sclerotherapy / Q000379:methods; D014057:Tomography, X-Ray Computed
chemical_list: D011994:Recombinant Proteins; D005167:Factor VII; C103587:recombinant FVIIa; D015942:Factor VIIa