Low dose, oral epsilon aminocaproic acid for renal papillary necrosis and massive hemorrhage in hemoglobin SC disease.
Renal papillary necrosis in sickling hemoglobinopathies can lead to significant complications, including hemorrhage, obstruction, and infection. Despite its frequency, there are limited therapies for protracted hemorrhage. In the past, massive hemorrhage was managed with nephrectomy. Here, we report a patient with hemoglobin SC disease and prolonged, life-threatening hemorrhage from papillary necrosis successfully treated with oral, low-dose epsilon aminocaproic acid (EACA). Although further study is warranted, this case illustrates the need to consider EACA in the conservative management of renal papillary necrosis and significant hemorrhage in sickle cell hemoglobinopathies.
Hematology Division, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Alexander
A
Gabrovsky
Abimbola
A
Aderinto
Abimbole
A
Aderinto
Melissa
M
Spevak
Elliot
E
Vichinsky
Linda M S
LM
Resar
D000293:Adolescent; D015119:Aminocaproic Acid / Q000008:administration & dosage*; D000933:Antifibrinolytic Agents / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D006450:Hemoglobin SC Disease / Q000150:complications / Q000188:drug therapy*; D006470:Hemorrhage / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007681:Kidney Papillary Necrosis / Q000150:complications / Q000188:drug therapy*; D008297:Male; D016896:Treatment Outcome
D000933:Antifibrinolytic Agents; D015119:Aminocaproic Acid