Eptacog-α

Reactions 1314 - 14 Aug 2010 S Eptacog-α Simultaneous arterial and venous thromboses in an elderly patient: case report A 68-year-old man developed simultaneous arterial and venous thromboses during treatment with IV eptacog-α [Novoseven] for a cerebral haemorrhage. The man was hospitalised and started receiving IV eptacog-α 6mg [sic; frequency not stated]; he had a history of hypertension, Churg-Strauss syndrome and eosinophilia, and had received lercanidipine, corticosteroids and inhaled antiasthmatics. Five days after eptacog-α initiation, he developed pain in his heels along with cutaneous necrosis. His dorsalis pedis and tibial pulses on the right side were not palpable. Doppler ultrasonography revealed a deep vein thrombosis on his right popliteal vein, extending up to the superficial vein at the upper third of his thigh. On the left side, he had deep vein thrombosis of his deep femoral vein, which was almost completely occluding his left common femoral vein. He also had occlusion up to the malleolus of his fibular, posterior tibial and dorsalis pedis arteries on the right. The man received buflomedil and heparin. However, he developed acute ischaemia of his right lower limb. The thrombosis progressed and resulted in dry gangrene, requiring amputation of his right lower limb. The amputation had a poor functional outcome, subsequently requiring above-knee amputation. Ten weeks after hospitalisation, he was transferred to a rehabilitation centre. Two months later, he was sent home, while receiving fluindione for secondary prevention. Author comment: This case illustrated the risk of thrombosis that can be serious during treatment with eptacog-α in nonhaemophiliac conditions. Nevertheless, it cannot be excluded that the patient’s underlying conditions played a role in the development of his thromboses. Schieveen PG-V, et al. Arterial and venous thrombosis by Eptacog alpha. Review of the literature about one case. [French]. Therapie 65: 139-141, No. 2, Apr 2010. Available from: URL: http://dx.doi.org/10.2515/therapie/2010007 [French; summarised from a translation] - France 803030910 1 Reactions 14 Aug 2010 No. 1314 0114-9954/10/1314-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved

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Reactions 1314 - 14 Aug 2010

SEptacog-αSimultaneous arterial and venous thromboses inan elderly patient: case report

A 68-year-old man developed simultaneous arterial andvenous thromboses during treatment with IV eptacog-α[Novoseven] for a cerebral haemorrhage.

The man was hospitalised and started receivingIV eptacog-α 6mg [sic; frequency not stated]; he had ahistory of hypertension, Churg-Strauss syndrome andeosinophilia, and had received lercanidipine,corticosteroids and inhaled antiasthmatics. Five days aftereptacog-α initiation, he developed pain in his heels alongwith cutaneous necrosis. His dorsalis pedis and tibialpulses on the right side were not palpable. Dopplerultrasonography revealed a deep vein thrombosis on hisright popliteal vein, extending up to the superficial vein atthe upper third of his thigh. On the left side, he had deepvein thrombosis of his deep femoral vein, which wasalmost completely occluding his left common femoral vein.He also had occlusion up to the malleolus of his fibular,posterior tibial and dorsalis pedis arteries on the right.

The man received buflomedil and heparin. However, hedeveloped acute ischaemia of his right lower limb. Thethrombosis progressed and resulted in dry gangrene,requiring amputation of his right lower limb. Theamputation had a poor functional outcome, subsequentlyrequiring above-knee amputation. Ten weeks afterhospitalisation, he was transferred to a rehabilitationcentre. Two months later, he was sent home, whilereceiving fluindione for secondary prevention.

Author comment: This case illustrated the risk ofthrombosis that can be serious during treatment witheptacog-α in nonhaemophiliac conditions. Nevertheless, itcannot be excluded that the patient’s underlying conditionsplayed a role in the development of his thromboses.Schieveen PG-V, et al. Arterial and venous thrombosis by Eptacog alpha. Reviewof the literature about one case. [French]. Therapie 65: 139-141, No. 2, Apr 2010.Available from: URL: http://dx.doi.org/10.2515/therapie/2010007 [French;summarised from a translation] - France 803030910