Successful treatment of veno-occlusive disease of the liver with urokinase in a patient with non-Hodgkin's lymphoma.
Leukemia
; 7(5): 760-3, 1993 May.
Article
em En
| MEDLINE
| ID: mdl-8483332
ABSTRACT
A 38-year-old man with a non-Hodgkin's lymphoma of intermediate grade malignancy attained partial remission after three courses of CHOP (cyclophosphamide+hydroxydaunorubicin+vincristine+prednisolone). He was assigned to undergo autologous bone marrow transplantation (ABMT). The conditioning regimen consisted of cyclophosphamide and whole body irradiation. Two weeks later he developed veno-occlusive disease (VOD) of the liver. Doppler sonography confirmed the diagnosis showing a reversal of the blood flow in the portal vein. In addition a large thrombus was present in the inferior caval vein. Protein C level was strongly reduced (28%). Because of clinical deterioration intravenous urokinase was started. The transaminases normalised rapidly and the patient showed a dramatic clinical improvement. There were no major bleeding complications. Repeat Doppler sonography showed a normal antegrade flow in the portal vein. This case suggests that a coagulopathy in the hepatic vascular bed might contribute to the development of VOD and that patients with VOD are at risk for other thrombotic complications. Furthermore it shows that urokinase with platelet support can be given safely and effectively to a patient with VOD and severe thrombocytopenia.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Hepatopatia Veno-Oclusiva
/
Linfoma não Hodgkin
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Ativador de Plasminogênio Tipo Uroquinase
Limite:
Adult
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Humans
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Male
Idioma:
En
Ano de publicação:
1993
Tipo de documento:
Article