Recombinant factor VIIa treatment for life‐threatening haemoptysis

Abstract

Diffuse alveolar haemorrhage is a severe clinical disorder that may be life-threatening. The early diagnosis of diffuse alveolar haemorrhage and prompt intervention is crucial. Recombinant factor VIIa has been used extensively for the treatment of haemophilia A and B patients. More recently, recombinant factor VIIa has been used successfully for the treatment of bleeding in patients without pre-existing coagulopathy. We describe the successful use of recombinant factor VIIa in a patient with diffuse alveolar haemorrhage secondary to pulmonary-renal syndrome.

Failure of Recombinant Activated Factor VII in Treatment of Diffuse Alveolar Hemorrhage due to Cryoglobulinemic Vasculitis

“…Doses that have been successful include intrapulmonary administration of 50 mcg/kg rFVIIa in 50 mL of sodium chloride by bronchoalveolar lavage with 25 mL in each of the bronchi [8, 9]. Intravenous regimens include 90 mcg/kg every 4 hours × 3 doses and repeated upon recurrent hemorrhage days later [10] and 90 mcg/kg in a single dose [5] and 120 mcg/kg every 3 hours × 3 doses [6]. DAH in the described case reports resolved with rFVIIa therapy; however, there were two case reports in which the patients died of their underlying disorder [7].…”

Treatment of Diffuse Pulmonary Hemorrhage with Factor VIIa

“…Several reports have focused on the successful use of rFVIIa to control diffuse pulmonary hemorrhage in non-injured patients with autoimmune disorders and after hematopoietic stem-cell transplantation [12][13][14][15][16][17].…”

Respirology year‐in‐review 2006: Clinical science

“…The journal also included two cases of recurrence of bronchiectasis after bilateral lung transplantation—a concern for future recipients 90 . Extending the use of Factor VIIa in haemophilia to a patient with diffuse alveolar haemorrhage from pulmonary–renal syndrome was demonstrated to be successful 91 …”