Severe Bleeding Diathesis Associated With Invasive Aspergillosis in Transplant Patients

Sl, McClellan; Ra, Komorowski; Sg, Farmer; Cv, Hussey; Hm, Kauffman; Mb, Adams

doi:10.1097/00007890-198504000-00014

Cited by 14 publications

(10 citation statements)

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“…(McClellan et al,1985). Furthermore, there are some suggestions that the ingestion of moldy food infected with A. fumigatus can cause fatal hemorrhagic disease in cattle and swine (Jubb et al, 1993).…”

Section: Discussionmentioning

confidence: 99%

Aspergillus Fumigatus Infection among Dromedary Camels in Saudi Arabia

Al-Hizab¹

2014

Adv. Anim. Vet. Sci.

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Section: Discussionmentioning

confidence: 99%

Aspergillus Fumigatus Infection among Dromedary Camels in Saudi Arabia

Al-Hizab¹

2014

Adv. Anim. Vet. Sci.

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“…She was successfully extubated on day +15 and was transferred out of the ICU to the BMT floor for further care. Treatment with recombinant FVIIa was continued for a total of 16 doses (days [12][13][14][15][16] and then was discontinued without any further evidence of hemorrhage noted. Unfortunately, the patient's overall condition continued to deteriorate over the next 2 weeks with the development of severe steroid-induced myopathy as well as a rapid weight loss of 8 kg over 7 days -both of which depict a 'failure to thrive' clinical presentation.…”

Section: Case Reportmentioning

confidence: 99%

“…10 Recent clinical data have also supported a correlation between both prothrombin time Bone Marrow Transplantation (PT) and bleeding time with factor X activation in the absence of tissue factor 12 in patients with bleeding secondary to thrombocytopenia, surgical procedure or liver dysfunction. [13][14][15][16] Our preliminary experience with rFVIIa involved a patient with acute leukemia with DAH following a matched unrelated donor bone marrow transplant.…”

mentioning

confidence: 99%

Treatment of diffuse alveolar hemorrhage after allogeneic bone marrow transplant with recombinant factor VIIa

Hicks

Peng

Gajewski

2002

Bone Marrow Transplant

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Summary:Diffuse alveolar hemorrhage (DAH) is a potentially lifethreatening pulmonary toxicity that occurs in 1-21% of patients following bone marrow transplantation. The syndrome is associated with a high mortality rate; and current treatment options are limited. Recombinant factor VIIa (rFVIIa, Novoseven) has recently been approved for the treatment of bleeding in patients with hemophilia A/B with inhibitors. A greater understanding of the mechanism by which rFVIIa restores hemostasis has recently become available; with in vitro evidence supporting that the thrombin burst achieved by rFVIIa is independent of the presence or binding to tissue factor. This insight has suggested a range of other potential clinical uses for the drug; including the setting of pulmonary hemorrhage. We review our experience with using rFVIIa for treatment of DAH in a patient with acute myelogenous leukemia following a matched unrelated donor bone marrow transplant. Boluses of 90 g/kg rFVIIa were given every 3 h × 4 doses/day, concurrently with high-dose corticosteroids and maintenance of a platelet count Ͼ50 000/mm 3 . Rapid clinical and radiological improvement was noted within several doses of rFVIIa, with discontinuation of the drug after eight doses. However, the patient's clinical condition began to rapidly deteriorate following cessation of rVIIa, resulting in reinstitution of therapy 24 h later. The patient again exhibited rapid clinical improvement; and rFVIIa was continued for an additional 16 doses with no further evidence of pulmonary hemorrhage noted. No toxicity or adverse events were observed with rFVIIa treatment. Our experience indicates that rFVIIa may be an effective treatment option for DAH post bone marrow transplant; although further clinical studies are needed before recommendations can be made regarding off label use of rFVIIa in this clinical setting.

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“…Invasive aspergillosis in immunosuppres sive patients is particularly dangerous be cause of the hemorrhagic diathesis it causes [80]. The most important among bacterial infections is probably pseudomembranous colitis caused by Clostridium difficile.…”

Section: Other Gi Complicationsmentioning

confidence: 99%

“…In infections caused by herpes, aciclovir has given good results. In the treatment of fulminant aspergillosis, e-aminocaproic acid, protamine sulfate and ice plasma have been given in addition to the antimycotic ampho tericin B but the results have not been favor able [80], Both vancomycin and metronida zole, perorally given, are approved for the specific treatment of pseudomembranous co litis. Relapses are quite common, however.…”

Section: Other Gi Complicationsmentioning

confidence: 99%