title: Failure of Recombinant Activated Factor VII in Treatment of Diffuse Alveolar Hemorrhage due to Cryoglobulinemic Vasculitis.
abstract: Diffuse alveolar hemorrhage (DAH) is a serious complication of the small vessel vasculitis syndromes and carries a high mortality. Recombinant activated factor VII (rFVIIa) is used to treat bleeding in patients with hemophilia and antibodies to factor VIII or IX. It is increasingly being used in life-threatening hemorrhage in a variety of other settings in which conventional therapy is unsuccessful. Randomized controlled trials of rFVIIa in DAH are lacking. However, several case reports have described a complete or sustained control of DAH using rFVIIa after patients failed to respond to medical treatment. There are no case reports in the literature describing the use or the failure of rFVIIa in DAH associated with cryoglobulinemic vasculitis. We here report the failure of rFVIIa to control DAH in a patient with CD5+ B-cell non-Hodgkin's lymphoma and cryoglobulinemic vasculitis.
authors.affiliation: Department of Internal Medicine, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI 48202, USA.
authors.forename: Dania
authors.initials: D
authors.lastname: Khoulani
authors.affiliation: Department of Internal Medicine, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI 48202, USA.
authors.forename: Bharat
authors.identifier: 0000-0002-3755-0036
authors.initials: B
authors.lastname: Rao
authors.affiliation: Department of Internal Medicine, Division of Hospital Medicine, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI 48202, USA.
authors.forename: Ammar
authors.initials: A
authors.lastname: Khanshour
authors.affiliation: Division of Hematology and Oncology, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI 48202, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Kuriakose
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI 48202, USA ; Division of Nephrology and Hypertension, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI 48202, USA.
authors.forename: Lenar
authors.identifier: 0000-0002-8955-1292
authors.initials: L
authors.lastname: Yessayan
references.citation: Thorax. 2004 Feb;59(2):130-5
references.pmid: 14760153
references.citation: Am J Respir Crit Care Med. 2002 Nov 1;166(9):1291-2
references.pmid: 12403702
references.citation: Crit Care Med. 2003 Apr;31(4 Suppl):S238-42
references.pmid: 12682446
references.citation: Rev Mal Respir. 2011 Jan;28(1):106-11
references.pmid: 21277485
references.citation: Ann Intern Med. 2004 Mar 16;140(6):493-4
references.pmid: 15023729
references.citation: Best Pract Res Clin Rheumatol. 2009 Jun;23(3):429-43
references.pmid: 19508949
references.citation: Crit Care Med. 2006 Mar;34(3):871-7
references.pmid: 16521285
references.citation: Biol Blood Marrow Transplant. 2007 May;13(5):622-3
references.pmid: 17448923
references.citation: N Engl J Med. 1997 Nov 20;337(21):1512-23
references.pmid: 9366584
references.citation: Cases J. 2008 Sep 12;1(1):150
references.pmid: 18789132
references.citation: Semin Arthritis Rheum. 2006 Dec;36(3):189-96
references.pmid: 16996578
references.citation: Respirology. 2006 Sep;11(5):652-4
references.pmid: 16916342
references.citation: Crit Care. 2006;10(6):R177
references.pmid: 17184515