A cerebrovascular event after single-dose administration of recombinant factor VIIa in a patient with esophageal variceal bleeding

• Published in: Digestive diseases and sciences 2006-09, Vol.51 (9), p.1647-1649
• Main Authors: AKYILDIZ, Murat, TURAN, Ilker, OZUTEMIZ, Omer, BATUR, Yucel, ILTER, Tankut
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Erythrocyte Transfusion; Esophageal and Gastric Varices - blood; Esophageal and Gastric Varices - complications; Esophageal and Gastric Varices - therapy; Esophagoscopy; Factor VII - adverse effects; Factor VIIa; Fatal Outcome; Feeding. Feeding behavior; Fundamental and applied biological sciences. Psychology; Gastroenterology. Liver. Pancreas. Abdomen; Gastrointestinal Hemorrhage - blood; Gastrointestinal Hemorrhage - etiology; Gastrointestinal Hemorrhage - therapy; Hepatic Encephalopathy - blood; Hepatic Encephalopathy - etiology; Hepatic Encephalopathy - mortality; Humans; Infarction, Middle Cerebral Artery - chemically induced; Infarction, Middle Cerebral Artery - diagnostic imaging; Infarction, Middle Cerebral Artery - therapy; Liver Cirrhosis - blood; Liver Cirrhosis - complications; Liver Cirrhosis - therapy; Liver Function Tests; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Other diseases. Semiology; Recombinant Proteins - adverse effects; Sclerotherapy - methods; Tomography, X-Ray Computed; Vertebrates: anatomy and physiology, studies on body, several organs or systems
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-005-9023-y

Upper gastrointestinal bleeding (UGIB) is a life-threatening complication of cirrhosis that develops from esophageal varices in almost 70% of patients. The mortality rate from the bleeding episodes is reported to be 30% [1-4]. Standard management of UGIB of cirrhotic patients is vasoactive therapy combined with endoscopic procedures such as endoscopic sclerotherapy and band ligation [5]. Currently, it is reported that recombinant activated fVIIa (Novoseven, NovoNordisc) can correct the prothrombin time in decompensated cirrhotic patients and also can be used safely in Child's B and C cirrhotic patients with UGIB [6-8]. Herein, we describe the first case report in the literature of a cerebrovascular event after the administration of a single dose of fVIIa in a cirrhotic patient with esophageal variceal bleeding.