Spontaneous knee hemarthrosis associated with enoxaparin treatment in a post covid 19 patient
International Journal of Rheumatic Diseases
; 26(Supplement 1):372-373, 2023.
Artigo
em Inglês
| EMBASE | ID: covidwho-2237247
ABSTRACT
Purpose:
To report a case of a 66-year- old Filipino male who developed spontaneous knee hemarthrosis following enoxaparin prophylaxis. Method(s) Case reportResult:
Case We report a case of a 66-year- old Filipino male who developed spontaneous hemarthrosis of the left knee following enoxaparin use as venous thromboembolism prophylaxis. Pertinent in the medical history was the diagnosis of chronic kidney disease and chronic respiratory failure as sequelae of COVID 19 infection. During the course of admission, the patient developed acute pain and swelling of the left knee. He was bedridden and no prior traumatic events were noted. Coagulation parameters were within normal range. Arthrocentesis revealed viscous hemorrhagic synovial fluid (25 ml) with fluid analysis showing predominance of red blood cells (Red blood cells 680,000/muL, White blood cells 7200/muL) with no crystals seen on polarizing microscopy. Microbial culture was negative. Intravenous methylprednisolone was given and enoxaparin was continued. One day post arthrocentesis, there was improvement of pain and joint function. Joint swelling resolved. Patient had no recurrence of joint pain and swelling. Ethical consideration Informed consent for both written and photographic content was secured and patient confidentiality was observed. Conclusion(s) Our patient is an elderly with chronic kidney disease who recently recovered from COVID 19 infection. He received prophylactic dose of enoxaparin at 40 mg every 24 hours subcutaneously. No other drugs that can affect hemostasis were given. The patient's bleeding parameters were within normal during admission and at the onset of hemarthrosis. We hypothesize that elderly patients with chronic kidney disease receiving low dose enoxaparin may present with spontaneous hemarthrosis even in the absence of trauma. Whether the association between history of recent COVID-19 infection and hemarthrosis is co incidental or causal remains to be elucidated. Prompt aspiration can provide early diagnosis and facilitate proper treatment. (Figure Presented).
adverse drug reaction; aged; arthralgia; arthrocentesis; aspiration; case report; chronic kidney failure; chronic respiratory failure; clinical article; complication; conference abstract; confidentiality; coronavirus disease 2019; diagnosis; drug therapy; early diagnosis; erythrocyte; Filipino (citizen); hemarthrosis; hemostasis; human; human cell; immobility; informed consent; injury; intravenous drug administration; joint function; joint swelling; knee; leukocyte; low drug dose; male; medical history; polarization microscopy; side effect; surgery; synovial fluid; thrombosis prevention; venous thromboembolism; enoxaparin; methylprednisolone
Texto completo:
Disponível
Coleções:
Bases de dados de organismos internacionais
Base de dados:
EMBASE
Tipo de estudo:
Estudo prognóstico
Tópicos:
Covid persistente
Idioma:
Inglês
Revista:
International Journal of Rheumatic Diseases
Ano de publicação:
2023
Tipo de documento:
Artigo
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