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Fibrinolytic therapy with rt-PA in a patient with paroxysmal nocturnal hemoglobinuria and Budd-Chiari syndrome.

Abstract
Paroxysmal nocturnal hemoglobinuria (PNH) is associated with a high risk of thrombosis, particularly in the peripheral, cerebral, and abdominal veins. We report a patient with an occlusion of the hepatic veins and a slit shape narrowing of the cava inferior consistent with the Budd-Chiari syndrome in whom intravenous fibrinolytic therapy with recombinant tissue plasminogen activator (rt-PA) was applied. Systemic rt-PA was given in a dose of 25 mg rt-PA over 3 h and 25 mg rt-PA as constant intravenous infusion over the next 21 h leading to an incomplete recanalization. The same protocol was applied again 2 days later, resulting in a complete recanalization of the hepatic veins and the vena cava inferior. Our case shows that exclusive systemic application of rt-PA can result in full anatomic and clinical restoration.
AuthorsA C Hauser, A Brichta, I Pabinger-Fasching, U Jäger
JournalAnnals of hematology (Ann Hematol) Vol. 82 Issue 5 Pg. 299-302 (May 2003) ISSN: 0939-5555 [Print] Germany
PMID12707719 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Tissue Plasminogen Activator
Topics
  • Adult
  • Body Weight (drug effects)
  • Budd-Chiari Syndrome (diagnostic imaging, drug therapy, etiology)
  • Female
  • Hemoglobinuria, Paroxysmal (complications, drug therapy)
  • Humans
  • Infusions, Intravenous
  • Thrombolytic Therapy (methods)
  • Tissue Plasminogen Activator (administration & dosage)
  • Treatment Outcome
  • Ultrasonography

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