Successful treatment of intractable hemothorax with recombinant factor VIIa in a nonhemophilic patient.
Recombinant factor VIIa (rFVIIa) was developed for the treatment of bleeding in hemophilic patients with inhibitors. It has also been used to stop bleeding in nonhemophilic patients who fail to respond to conventional treatment. We report a case of catastrophic hemothorax in which bleeding was stopped by administration of rFVIIa. A 68-year-old woman with chronic hepatitis C-related liver cirrhosis was admitted due to pneumonia and parapneumonic effusion. The patient developed hemothorax and hypovolemic shock after thoracentesis. Conventional therapies including tube thoracostomy and transarterial embolization failed to stop the life-threatening bleeding. The bleeding stopped after administration of rFVIIa 100 microg/kg/BW at 2-hour intervals for a total of two doses on the 3rd day of hospitalization. Despite intensive care, however, the patient died due to nosocomial infection and multiple organ failure on the 12th day of hospitalization. Hemothorax in a nonhemophilic patient can be successfully treated with rFVIIa.
Wei
Yu-Feng
YF
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Ho
Chao-Chi
CC
Lin
Ming-Tzer
MT
Yuan
Ang
A
Yu
Chong-Jen
CJ
D000368:Aged; D002908:Chronic Disease; D004334:Drug Administration Schedule; D005167:Factor VII / Q000008:administration & dosage*; D015942:Factor VIIa; D005260:Female; D006491:Hemothorax / Q000188:drug therapy*; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology; D011994:Recombinant Proteins / Q000008:administration & dosage
D011994:Recombinant Proteins; D005167:Factor VII; C103587:recombinant FVIIa; D015942:Factor VIIa