Spontaneous leg haematoma in a patient anticoagulated with nadroparin for suspected pulmonary thromboembolism [1]
Yükleniyor...
Dosyalar
Tarih
2004
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Fixed-dose, subcutaneous Low Molecular Weight Heparin (LMWH) is as effective
and safe as adjusted-dose, intravenous unfractionated heparin (UFH) for the initial management of venous thromboembolism and
symptomatic pulmonary thromboembolism
[1–4]. Clinical experiences indicate that
bleeding is a major side effect, not only of
UFH, but also of LMWH [5].
An 81-year-old woman (60 kg) was admitted with a clinically suspected pulmonary
embolism (SPE) with a 2-day history of pleuritic chest pain and dyspnoea. Her past medical history showed congestive heart failure,
atrial fibrillation (AF) and hyperthyroidism,
immobilisation due to femoral head fracture
7 years previously. Propylthiouracilcoumadin, aspirin, perindopril, spironolactone, and
digoxin were started in May 2000 and propylthiouracil and coumadin was discontinued
after 3 months follow-up. Owing both to SPE
and chronic AF she was started on nadroparin
subcutaneously twice daily 5700 UI AXa/
0.6 ml. The ventilation/perfusion scan of the
lung was reported as having low probability of
pulmonary embolism and a duplex ultrasound
of the lower limbs was negative for DVT
the night after the symptoms started. Despite
these findings anticoagulant treatment was
continued due to the chronic AF. Except for
slightly raised white blood cells and a raised
creatinine on admission her laboratory results
and coagulation parameters were within normal limits. Two days after anticoagulant treatment, she complained of sudden onset of left
leg pain with the finding of a tender haematoma (measuring 51025 cm). There was
no history of trauma. Together with nadroparin aspirin was also discontinued.
Açıklama
Anahtar Kelimeler
Spontaneous, Haematoma, Thromboembolism
Kaynak
Swiss Medical Weekly
WoS Q Değeri
Scopus Q Değeri
Q2
Cilt
134
Sayı
7-8
