Deep vein thrombosis in a patient with severe haemophilia A

Kashyap, Rajesh; Sharma, Lovepriya; Gupta, Shreya; Saxena, Renu; Srivastava, Dina N.

doi:10.1111/j.1365-2516.2006.01179.x

Cited by 20 publications

(17 citation statements)

References 10 publications

(25 reference statements)

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“…Only a handful of cases of spontaneous VTE in (untreated) hemophilia have been reported in the literature. 22,23 Spontaneous VTE is also rare in patients with VWD: in a recently published review of 486 VWD patients at a single institution, for instance, there were no cases of venous thrombosis. 24 A literature review within the same publication reported 33 cases of VWD and venous thrombosis, with all but 7 cases having identifiable risk factors; the most common risk factor (N 5 14) was factor replacement therapy consisting of VWF with FVIII.…”

Section: Vte In Bleeding Disordersmentioning

confidence: 99%

How I treat patients with inherited bleeding disorders who need anticoagulant therapy

Martin

Key

2016

Blood

106

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Situations that ordinarily necessitate consideration of anticoagulation, such as arterial and venous thrombotic events and prevention of stroke in atrial fibrillation, become challenging in patients with inherited bleeding disorders such as hemophilia A, hemophilia B, and von Willebrand disease. There are no evidence-based guidelines to direct therapy in these patients, and management strategies that incorporate anticoagulation must weigh a treatment that carries a risk of hemorrhage in a patient who is already at heightened risk against the potential consequences of not treating the thrombotic event. In this paper, we review atherothrombotic disease, venous thrombotic disease, and atrial fibrillation in patients with inherited bleeding disorders, and discuss strategies for using anticoagulants in this population using cases to illustrate these considerations.

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Section: Vte In Bleeding Disordersmentioning

confidence: 99%

How I treat patients with inherited bleeding disorders who need anticoagulant therapy

Martin

Key

2016

Blood

106

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“…Other risk factors can be listed as congenital prothrombotic condition in heterozygote level, deficiency of protein C and Factor V Leiden [8]. In addition to these, Kashyap et al .…”

Section: Discussionmentioning

confidence: 99%

“…In addition to these, Kashyap et al . have shown that FII G20210A mutation is another risk factor [8]. …”

Section: Discussionmentioning

confidence: 99%

“…Dargaud et al have used unfractioned heparin for a month subsequent to Factor VIII replacement [2]; Kashyap et al have administered low molecular weight heparin for 9 weeks [8]; Ettinsghausen et al have applied low molecular weight heparin together with Factor VIII replacement, after unfractioned heparin for 14 days. The oral anticoagulant drugs were not a preference since they increase hemorrhage risk.…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous deep vein thrombosis in hemophilia A: a case report

Biçer¹,

Yanar²,

Tüydeş³

2009

Cases J

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Venous thromboembolus is an important cause of hospital acquired morbidity and mortality. Venous thrombosis is a very rare occurrence in patients with haemophilia A. The thrombosis originated from the right main and external iliac veins, and effects the cranial segments of the main, deep and superficial femoral veins as an acute phase thrombus. Neither any local anatomic compression nor any predisposing thrombophilic risk factors were identified. We treated the patient with enoxaparine 1 mg/kg twice a day subcutaneously and then started oral anticoagulation with warfarin.

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“…Without VTE prophylaxis, 60% of patients with normal haemostatic systems undergoing major orthopaedic surgery develop a postoperative VTE [50]. Although symptomatic venous thrombosis or pulmonary embolism has been described in patients with haemophilia without inhibitors, there is little information on clinical incidence or prevention [51][52][53][54][55][56]. Although limited in sample size, a 10% incidence of subclinical deep vein thrombosis (DVT), diagnosed by ultrasound, was reported among 20 haemophilia patients without inhibitors undergoing 29 major orthopaedic surgeries [57].…”

Section: Venous Thromboembolism Prophylaxis Following Major Surgerymentioning

confidence: 99%

Multidisciplinary management of patients with haemophilia with inhibitors undergoing surgery in the United States: perspectives and best practices derived from experienced treatment centres

Escobar¹,

Maahs

Hellman

et al. 2012

Haemophilia

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Since the 1980s, major surgical interventions in patients with congenital haemophilia with inhibitors have been performed utilizing bypassing agents for haemostatic coverage. While reports have focused on perioperative management and haemostasis, the US currently lacks consensus guidelines for the management of patients with inhibitors during the surgical procedure, and pre- and postoperatively. Many haemophilia treatment centres (HTCs) have experience with surgery in haemophilia patients, including those with inhibitors, with approximately 50% of these HTCs having performed orthopaedic procedures. The aim of this study was to present currently considered best practices for multidisciplinary care of inhibitor patients undergoing surgery in US HTCs. Comprehensive haemophilia care in the US is provided by ~130 federally designated HTCs staffed by multidisciplinary teams of healthcare professionals. Best practices were derived from a meeting of experts from leading HTCs examining the full care spectrum for inhibitor patients ranging from identification of the need for surgery through postoperative rehabilitation. HTCs face challenges in the care of inhibitor patients requiring surgery due to the limited number of surgeons willing to operate on this complex population. US centres of excellence have developed their own best practices around an extended comprehensive care model that includes preoperative planning, perioperative haemostasis and postoperative rehabilitation. Best practices will benefit patients with inhibitors and allow improvement in the overall care of these patients when undergoing surgical procedures. In addition, opportunities for further education and outcomes assessment in the care of this patient population have been identified.

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Deep vein thrombosis in a patient with severe haemophilia A

Abstract: A 25-year-old male with severe haemophilia A developed deep vein thrombosis of the left upper limb. Venography showed thrombosis of the basilic vein. There was no underlying prothrombotic condition. He was successfully treated with low-molecular weight heparin.

Cited by 20 publications

References 10 publications

How I treat patients with inherited bleeding disorders who need anticoagulant therapy

How I treat patients with inherited bleeding disorders who need anticoagulant therapy

Spontaneous deep vein thrombosis in hemophilia A: a case report

Multidisciplinary management of patients with haemophilia with inhibitors undergoing surgery in the United States: perspectives and best practices derived from experienced treatment centres

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