title: Successful management of intra-abdominal hemorrhage in the presence of severe alcoholic liver disease with activated recombinant factor VII (rFVIIa; NovoSeven): a case report and review of the literature on approved and off-label use of rFVIIa.
abstract: A 37-year-old male with history of alcohol abuse presented to us with nausea, vomiting, and abdominal pain with ascites. He was diagnosed with alcoholic liver disease with coagulopathy and pancreatitis. During hospitalization, the patient developed intra-abdominal hemorrhage. He was treated with platelets, packed red blood cells and fresh frozen plasma without any improvement. Following this he was treated with activated recombinant factor VII (90 microg/kg), which resulted in normalization of the prothrombin time and the activated partial thromboplastin time and stabilization of hematocrit within a few hours. We review the current literature on the approved and off-label use of activated recombinant factor VII.
authors.affiliation: Division of Hematology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah 84112, USA. neeraj.agarwal@hsc.utah.edu
authors.forename: Neeraj
authors.initials: N
authors.lastname: Agarwal
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Spahr
authors.forename: George M
authors.initials: GM
authors.lastname: Rodgers
mesh_terms: D000005:Abdomen / Q000473:pathology*; D000328:Adult; D000437:Alcoholism; D001780:Blood Coagulation Tests; D019468:Disease Management; D005167:Factor VII / Q000627:therapeutic use*; D015942:Factor VIIa; D006400:Hematocrit; D006470:Hemorrhage / Q000188:drug therapy*; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D010195:Pancreatitis; D011994:Recombinant Proteins / Q000627:therapeutic use; D016879:Salvage Therapy; D019851:Thrombophilia
chemical_list: D011994:Recombinant Proteins; D005167:Factor VII; C103587:recombinant FVIIa; D015942:Factor VIIa