Recombinant factor VIIa use in refractory ulcer bleeding in uremic patient

• Published in: The American journal of emergency medicine 2012-09, Vol.30 (7), p.1319.e1-1319.e4
• Main Authors: Wang, An-Yi, MD, Yuan, Ang, MD, PhD, Huang, Chien-Hua, MD, PhD, Chang, Wei-Tien, MD, PhD, Liang, Po-Chin, MD, Lin, Tzu-Hsin, MD, Chen, Shyr-Chyr, MD, MBA
• Format: Article
• Language: English
• Subjects: Abdomen; Adult; Duodenal Ulcer - complications; Duodenal Ulcer - diagnostic imaging; Duodenum - diagnostic imaging; Emergency; Emergency medical care; Factor VIIa - therapeutic use; Hemorrhage; Hospitalization; Hospitals; Humans; Kidney Failure, Chronic - complications; Male; Medical imaging; Peptic Ulcer Hemorrhage - complications; Peptic Ulcer Hemorrhage - diagnostic imaging; Peptic Ulcer Hemorrhage - drug therapy; Recombinant Proteins - therapeutic use; Tomography, X-Ray Computed; Ulcers
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2011.05.010

Peptic ulcer bleeding is thought to be a major cause of bleeding in patients with end-stage renal disease and is more complicated in uremic patients. We described a 41-year-old man with end-stage renal disease who underwent hemodialysis with refractory ulcer bleeding, failure to all traditional peptic ulcer treatments, and correction of uremic component, who has been successfully treated by using recombinant factor VIIa. There have been few case reports in dealing refractory upper gastrointestinal bleeding in uremic patients in the literature; and in this case report, we demonstrates that recombinant factor VIIa could be used as a rescue therapy in these high–surgical risk patients when medical therapy fails.