[The recurrence of pulmonary embolism during heparin therapy after thrombolysis in the acute phase: a clinical case report]. / Recidiva di embolia polmonare in corso di terapia eparinica dopo trombolisi in fase acuta: descrizione di un caso clinico.
G Ital Cardiol
; 23(4): 357-63, 1993 Apr.
Article
em It
| MEDLINE
| ID: mdl-8319864
ABSTRACT
We report a case of a 61-year-old woman admitted to our Coronary Care Unit for pulmonary embolism following cholecystectomy. After thrombolytic therapy, and during treatment with heparin (administered as a continuous intravenous infusion in the standard dose), the patient had a recurrence of pulmonary embolism and a subsequent implant of a Gianturco-Rohem vena cava filter. The patient presented an initial reduction in the number of platelets from 477 x 10(3)/microliters to 360 x 10(3)/microliters that was ascribed to a heparin side effect or to a blocking of the platelets in a massive pulmonary thrombosis. A predischarge platelet count, however, showed an elevated number of thrombocytes (944 x 10(3)/microliters) and hyperfibrinogenemia (fibrinogen = 750 mg/dl). Essential thrombocythemia was demonstrated and treated with interferon alpha-2b-recombinant 3,000,000 U.I. on alternate days with a reduction in platelets to 450 x 10(3)/microliters. This case demonstrates the necessity of exploring, during pulmonary embolism, all possible causes of hypercoagulability in the course of thrombolytic therapy.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Embolia Pulmonar
/
Heparina
/
Terapia Trombolítica
/
Ativador de Plasminogênio Tecidual
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
Limite:
Female
/
Humans
/
Middle aged
Idioma:
It
Revista:
G Ital Cardiol
Ano de publicação:
1993
Tipo de documento:
Article