title: Hypofibrinogenemia induced by tigecycline: a potentially life-threatening coagulation disorder.
abstract: A 74-year-old female patient with end-stage renal disease, undergoing periodic hemodialysis, was hospitalized due to infection by multidrug-resistant Acinetobacter baumannii after hip replacement surgery. She was treated with tigecycline, a glycylcycline agent. Subsequently she developed coagulation disorders as substantiated by increased international normalized ratio (INR), prolonged partial thromboplastin time (aPTT), and severe hypofibrinogenemia, followed by transaminasemia, cholestasis, and anemia. Ultrasonography and computed tomography revealed no underlying pathological entities. Tigecycline was discontinued and the patient underwent daily hemodialysis and received multiple fresh frozen plasma transfusions. Additionally, she was treated with colistin. Her clinical and laboratory status improved. We suggest that patients treated with tigecycline should be monitored for changes in INR, aPTT, and fibrinogen levels to avoid severe, life-threatening coagulation disturbances.
authors.affiliation: From the 1 Nephrological Department, General Hospital of Pella , Edessa , Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Sabanis
authors.forename: Eleni
authors.initials: E
authors.lastname: Paschou
authors.forename: Eleni
authors.initials: E
authors.lastname: Gavriilaki
authors.forename: Asterios
authors.initials: A
authors.lastname: Kalaitzoglou
authors.forename: Sotirios
authors.initials: S
authors.lastname: Vasileiou
mesh_terms: D000151:Acinetobacter Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D040981:Acinetobacter baumannii; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001778:Blood Coagulation Disorders / Q000139:chemically induced* / Q000175:diagnosis; D003091:Colistin / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D007676:Kidney Failure, Chronic / Q000150:complications*; D008911:Minocycline / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010314:Partial Thromboplastin Time; D006435:Renal Dialysis; D000078304:Tigecycline
chemical_list: D000900:Anti-Bacterial Agents; D000078304:Tigecycline; D008911:Minocycline; D003091:Colistin
keywords: Hypofibrinogenemia; acinetobacteur baumannii; adverse event; coagulation disorder; hemodialysis; tigecycline