Successful Treatment of Diffuse Alveolar Hemorrhage with Activated Factor VII
Authors: David Henke, Ronald J. Falk, Don A. Gabriel
Journal: Annals of Internal Medicine (2004)

Letters16 March 2004Successful Treatment of Diffuse Alveolar Hemorrhage with Activated Factor VIIDavid Henke, MD, MPH, Ronald J. Falk, MD, and Don A. Gabriel, MD, PhDDavid Henke, MD, MPHFrom University of North Carolina at Chapel Hill, Chapel Hill, NC 27599., Ronald J. Falk, MDFrom University of North Carolina at Chapel Hill, Chapel Hill, NC 27599., and Don A. Gabriel, MD, PhDFrom University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-6-200403160-00033 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: Life-threatening diffuse alveolar hemorrhage has been successfully treated with recombinant-activated human factor VII (rFVIIa) in 3 different conditions: 2 small-vessel vasculitis–associated diseases and bone marrow transplantation (1). Diffuse alveolar hemorrhage was confirmed by bronchoscopy demonstrating progressively bloodier aliquots of bronchoalveolar lavage fluid.Objective: To investigate the therapeutic efficacy of rFVIIa for diffuse alveolar hemorrhage.Case Reports: In case 1, diffuse alveolar hemorrhage, with antineutrophil cytoplasmic autoantibody–associated microscopic polyangiitis, occurred 3 weeks after a viral illness in a 53-year-old man. Progressive anemia and hypoxia prompted intubation within 24 hours of admission despite therapy with 2 plasma exchanges, ...References1. Fraser RS, Muller NL, Colman N, Pare ED, Bralow L, eds. Fraser and Pare's Diagnosis of Diseases of the Chest. 4th ed. Philadelphia: WB Saunders; 1999. Google Scholar2. Hogan SL, Nachman PH, Wilkman AS, Jennette JC, Falk RJ. Prognostic markers in patients with antineutrophil cytoplasmic autoantibody-associated microscopic polyangiitis and glomerulonephritis. J Am Soc Nephrol. 1996;7:23-32. [PMID: 8808106] CrossrefMedlineGoogle Scholar3. Brandt JT, Triplett DA, Alving B, Scharrer I. Criteria for the diagnosis of lupus anticoagulants: an update. On behalf of the Subcommittee on Lupus Anticoagulant/Antiphospholipid Antibody of the Scientific and Standardisation Committee of the ISTH. Thromb Haemost. 1995;74:1185-90. [PMID: 8560433] CrossrefMedlineGoogle Scholar4. Roberts HR, Monroe DM, Oliver JA, Chang JY, Hoffman M. Newer concepts of blood coagulation. Haemophilia. 1998;4:331-4. [PMID: 9873750] CrossrefMedlineGoogle Scholar5. Lawson JH, Mann KG. Cooperative activation of human factor IX by the human extrinsic pathway of blood coagulation. J Biol Chem. 1991;266:11317-27. [PMID: 2040636] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.Acknowledgments: The authors thank Dr. Harold Roberts for help with the Discussion section and Jean Brown and Melissa Lawrence for editorial and secretarial assistance. They also thank the clinical teams who cared for the patients. 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YesClinical Role of Recombinant Factor Vlla in Bleeding Disorders 16 March 2004Volume 140, Issue 6Page: 493-494KeywordsAntiphospholipid syndromeAttentionBlood plasmaBone marrow transplantationHemorrhageNephritisPlateletsSodiumThrombinVasculitis ePublished: 16 March 2004 Issue Published: 16 March 2004 CopyrightCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...