Renal thromboembolism during treatment with recombinant activated factor VII (rFVIIa) in a child with hemophilia B with factor IX inhibitors

BMC Pediatr. 2014 Dec 17:14:315. doi: 10.1186/s12887-014-0315-2.

Abstract

Background: Serious thromboembolic events connected with rFVIIa therapy in hemophilia patients are rare. Only three cases are reported in children, all of them with hemophilia A.

Case presentation: We present unique case of patient with hemophilia B and high titer inhibitors to coagulation FIX, who developed severe renal damage due to thromboembolic event during rFVIIa therapy, associated with unsuspected renovascular anomalies.

Conclusion: Caution is necessary if hematuria B requires administration of rFVIIa. US color doppler renal imaging before and after drug administration should be sufficient as an early warning.

Publication types

  • Case Reports

MeSH terms

  • Blood Coagulation Factor Inhibitors / metabolism
  • Child
  • Factor IX / antagonists & inhibitors*
  • Factor VIIa / adverse effects*
  • Hematuria / blood
  • Hematuria / drug therapy
  • Hemophilia B / blood*
  • Hemophilia B / drug therapy*
  • Humans
  • Kidney / blood supply*
  • Male
  • Recombinant Proteins / adverse effects
  • Thromboembolism / chemically induced*

Substances

  • Blood Coagulation Factor Inhibitors
  • Recombinant Proteins
  • Factor IX
  • recombinant FVIIa
  • Factor VIIa