Prothrombin complex concentrate (Octaplex®) for postsurgical bleeding control in a Stauffer’s syndrome

Fernández, Ana Belén Méndez; Ávila, Azahara Sancho de

doi:10.1007/s00277-011-1396-8

Cited by 7 publications

(3 citation statements)

References 4 publications

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“…The classical variant presents with flank mass, loin pain, and hematuria, with an associated cholestatic abnormality in liver function tests such as elevated alkaline phosphatase, erythrocyte sedimentation rate, α-2-globulin, and γ-glutamyl transferase, hypoalbuminemia, thrombocytosis, prolongation of prothrombin time [16][17][18][19][20][21][22][23][24][25].…”

Section: Clinical Featuresmentioning

confidence: 99%

Stauffer syndrome: a comprehensive review of the disease and diagnostic plan proposal

et al. 2022

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Stauffer syndrome, first described by Herbert Stauffer in 1961, is a hepatic paraneoplastic syndrome characterized by multiple extrahepatic malignancies, most commonly renal cell carcinoma. The syndrome manifests a wide range of symptoms caused by various pathophysiological mechanisms and presents with abnormalities in liver function tests in either cholestatic or non-cholestatic patterns.Stauffer’s syndrome is classified into two types: classical and jaundice variants. Some crossovers continue to occur, complicating the diagnosis of such a rare and frequently missed syndrome, which can be the only diagnostic clue for the retrograde detection of a hidden malignancy.To bridge the gap regarding such an important, but still unrecognized, syndrome, not only did we thoroughly cover what had previously been proposed in the literature, but we also proposed a diagnostic protocol based on multicenter experience with such a rare disease.

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Section: Clinical Featuresmentioning

confidence: 99%

Stauffer syndrome: a comprehensive review of the disease and diagnostic plan proposal

et al. 2022

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“…In comparison, the first case of the cholestatic, or icteric, variant of Stauffer's syndrome was reported by Dourakis et al in 1997 [18] . Since then, a total of 7 case reports describing the icteric variant of Staffer's syndrome were found on our review of the literature [19][20][21][22][23][24][25] . Direct hyperbilirubinemia was also noted in the patient described above.…”

Section: Al-taee Am Et Al Non-metastatic Hepatic Dysfunctionmentioning

confidence: 99%

An Unusual Case of Cholestatic Hepatitis

Al-Taee

Gremida

Cheung

et al. 2017

Journal of Gastroenterology and Hepatology Research

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resection of the primary tumor. Here we present an unusual case of non-metastatic hepatic dysfunction secondary to renal cell carcinoma, also known as Stauffer's syndrome, in a 55-year old patient who presented with liver synthetic dysfunction and notable hyperbilirubinemia. Unlike earlier reports, the icteric variant of Staffer's syndrome has been emerging as the predominantly reported variant in the recent literature. Moreover, poor correlation between the severity of hepatic dysfunction and the liver biopsy findings was noted. The variable and non-specific presenting symptoms and signs as well as the need for extensive evaluation for abnormal liver chemistry usually results in a delay in the diagnosis of the primary tumor. Therefore, physicians need to be familiar with this clinical entity as a possible reversible etiology of liver chemistry abnormalities in patients with renal and other solid tumors as this may guide further investigations, lead to earlier diagnosis and treatment of the primary tumor, and ultimately improve outcomes. INTRODUCTIONNon-metastatic hepatic dysfunction secondary to renal cell carcinoma, also known as Stauffer's syndrome, was first described by Stauffer in 1961 [1] . The pathophysiology has not been completely elucidated so far. Surgical resection of the primary tumor is characteristically associated with reversal of liver chemistry abnormalities [2] . CASE PRESENTATIONA 55-year-old Caucasian male with a past medical history of type 2 diabetes mellitus and benign prostatic hyperplasia presented to the emergency room with the chief complaint of worsening abdominal ABSTRACTRenal cell carcinoma can present with a variety of paraneoplastic syndromes. Reversible hepatic dysfunction in the setting of nonmetastatic renal cell carcinoma is a rare paraneoplastic phenomenon that was first described by Stauffer in 1961. This clinical entity is characterized by reversal of liver chemistry abnormalities after CASE REPORT

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“…It rapidly reverses these coagulation factors and corrects international normalized ratio (INR), and has a number of advantages compared to FFP, including lower volume of infusion, better safety, lower risk of transmission of blood-borne infections, no need to match the blood group, better efficacy and easier storage (5-7). Although the use of PCC for rapid reversal of oral anticoagulants is well studied (6, 8-10), there are a few studies on the efficacy of PCC to manage bleeding in patients with liver disease or patients with high INR who are scheduled to undergo surgery (11-13). …”

Section: Introductionmentioning

confidence: 99%

Management of Bleeding in Post-liver Disease, Surgery and Biopsy in Patients With High Uncorrected International Normalized Ratio With Prothrombin Complex Concentrate: An Iranian Experience

Parand

Honar

Aflaki

et al. 2013

Iran Red Cres Med J

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Background:To evaluate the efficacy of prothrombin complex concentrate (PCC) in the management of bleeding in patients with liver disease and patients undergoing surgery or biopsy who had a high uncorrected international normalized ratio (INR).Objectives:In this study, we examined an Iranian sample and investigated the efficacy of PCC to manage bleeding in patients with liver disease and also patients with high uncorrected INR who were scheduled for surgery or biopsy.Materials and Methods:A total of 25 patients including 16 patients with post-liver disease bleeding (group 1) and 9 patients with high uncorrected INR who were scheduled for surgery or biopsy (group 2) were enrolled. All patients were treated with 25 IU/kg PCC, and efficacy was defined as any reduction in or cessation of bleeding episodes and correction of INR before surgery or biopsy. The patients were also evaluated for any adverse effects.Results:INR decreased significantly in both groups of patients, with no bleeding episodes during or after the study in group 1 and during or after surgery/biopsy in group 2. All patients tolerated the therapy well without any significant adverse effects.Conclusions:The efficacy of PCC therapy was satisfactory in this study. PCC therapy in patients with liver disease and patients undergoing surgery or biopsy seems to be effective and safe, and may be a good treatment strategy for these patients, if fresh frozen plasma or vitamin K are not effective.

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Prothrombin complex concentrate (Octaplex®) for postsurgical bleeding control in a Stauffer’s syndrome

Cited by 7 publications

References 4 publications

Stauffer syndrome: a comprehensive review of the disease and diagnostic plan proposal

Stauffer syndrome: a comprehensive review of the disease and diagnostic plan proposal

An Unusual Case of Cholestatic Hepatitis

Management of Bleeding in Post-liver Disease, Surgery and Biopsy in Patients With High Uncorrected International Normalized Ratio With Prothrombin Complex Concentrate: An Iranian Experience

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