Eptacog alfa
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Cerebral infarction: case report A 42-year-old man with liver cirrhosis, who had oesophageal variceal and colonic bleeding, developed hepatic encephalopathy and started receiving IV eptacog alfa [recombinant factor VIIa] 80 µg/kg. After 36 hours, he experienced left hemiplegia and numbness; a cerebral infarction of the right middle cerebral artery area was revealed by cranial CT scan. Laboratory investigations showed the following levels: protein C 40% (normal 70–140), protein S 63% (60–130), antithrombin III 29% (75–125) and homocysteine 5.5 mmol/L (5–15 nmol/L). After another three bleeding episodes, he was listed for liver transplantation, but his bilirubin level increased to 50 mg/dL and he died from hepatorenal syndrome and progressive hepatic encephalopathy. Author comment: "[W]hile the patient was actively bleeding, the thrombotic event could not be attributed to the hemostatic disorder which results from advanced cirrhosis. In addition to this, the cerebrovascular event developed after [eptacog alfa] administration, which we believed played a major etiologic role." Akyildiz M, et al. A cerebrovascular event after single-dose administration of recombinant factor VIIa in a patient with esophageal variceal bleeding. Digestive 801045217 Diseases and Sciences 51: 1647-1649, No. 9, 2006 - Turkey
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Reactions 14 Oct 2006 No. 1123
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