An unusual presentation and treatment of a hemorrhaging plexiform neurofibroma

NF manifests as characteristic cutaneous pigmentation (café au lait lesions and freckles in groin and axillary regions), optic gliomas, osseous lesions, and benign peripheral nerve tumors [3]. Initial workup revealed a systolic blood pressure in the 60s–80s mmHg, Hemoglobin of 1.3 g/dL, D-dimer 11,7...

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Bibliographic Details
Published in:The American journal of emergency medicine 2021-06, Vol.44, p.479.e3-479.e4
Main Authors: Yocum, Andrew D., Bacharach, Dana, Simon, Erin L.
Format: Article
Language:English
Subjects:
Blood pressure
Embolization
Emergency medical care
Erythrocytes
Fibrinogen
Hemoglobin
Hemorrhage
Lactic acid
Lesions
Patients
Peripheral nerves
Pigmentation
Plexiform neurofibroma
Surgery
Tumors
Veins & arteries
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Summary:NF manifests as characteristic cutaneous pigmentation (café au lait lesions and freckles in groin and axillary regions), optic gliomas, osseous lesions, and benign peripheral nerve tumors [3]. Initial workup revealed a systolic blood pressure in the 60s–80s mmHg, Hemoglobin of 1.3 g/dL, D-dimer 11,710 ng/mL, fibrinogen of 74 mg/dL, Lactate of 7.7 mmol/L, pH of 7.157 and prolonged coagulation studies. Intraoperatively the patient underwent massive transfusion protocol and received an additional 25 units of packed red blood cells, 1 unit of fresh frozen plasma, 3 units of platelets, and 1 unit of cryoprecipitate.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2020.10.080