Hemothorax under thrombolytic therapy with recombinant tissue: plasminogen activator (rt-PA) in a 16-year-old girl.

Abstract

We present the case of a 16-year-old girl with an extended thrombosis of the femoral and iliac vein and the inferior vena cava during pleuropneumonia; predisposing risk factors for thrombophilia were: use of contraceptives, nicotine abuse and congenital deficiency of antithrombin III (not previously diagnosed). Thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA; initial dose: 0.08 mg/kg/h) was started. 2 days later--after diagnosis of an extended hemothorax: 1500 ml blood were obtained after thoracocentesis, transfusion of packed red blood cells was necessary--rt-PA was stopped, with only heparin (400 U/kg/d) being administered. 36 h later--the thrombosis had not yet changed--the thrombolytic therapy with rt-PA was continued in a markedly reduced dose (0.015 mg/kg/d) with no further bleeding complications. 8 days later--after successful thrombolysis--t-PA was stopped, heparin was given for another 10 days, then cumarin was administered orally.

• Authors: V Varnholt, H Ringe, L Nietsch, G Gaedicke
• Journal: European journal of pediatrics (Eur J Pediatr) Vol. 158 Suppl 3 Pg. S140-2 (Dec 1999) ISSN: 0340-6199 [Print] Germany
• PMID: 10650854 (Publication Type: Case Reports, Journal Article)

Chemical References

• Recombinant Proteins
• Tissue Plasminogen Activator

Topics

• Adolescent
• Female
• Hemothorax (chemically induced)
• Humans
• Pleuropneumonia (complications)
• Recombinant Proteins
• Thrombolytic Therapy (adverse effects)
• Tissue Plasminogen Activator (adverse effects)
• Venous Thrombosis (complications, drug therapy)