Nadroparin calcium/ozagrel/sulodexide
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Spontaneous retroperitoneal haemorrhage in an elderly patient: case report A 67-year-old woman with diabetic nephropathy developed a spontaneous retroperitoneal haemorrhage following administration of nadroparin calcium, ozagrel and sulodexide. The woman, who had a history of type 2 diabetes mellitus with diabetic retinopathy, was admitted with severe body oedema, a vascular lesion and renal insufficiency. She initially received insulin, amlodipine and a diuretic. She also started receiving IV administration of ozagrel and sulodexide [dosages not stated], plasma and human serum albumin. Six days after admission, she commenced haemodialysis every other day, with nadroparin calcium 0.025 mg/kg/h for anticoagulation [route not clearly stated]. After six haemodialysis sessions, her oedema had improved; however, on hospital day 15, she reported severe pain, numbness and swelling in her left hip and thigh. Tests showed hypotension and decreased haemoglobin levels. Abdominal ultrasound and CT findings confirmed a haematoma in the left retroperitoneal space. Nadroparin calcium was immediately withdrawn, and the woman received conservative treatment, including packed RBCs and carbazochrome sodium sulphonate. She had a rapid response to therapy, and underwent continuous venovenous haemofiltration with sodium citrate. After 3 days of treatment, her symptoms improved and her haemoglobin levels increased. Follow-up CT revealed the haematoma had partially absorbed. She was discharged with stable vital signs and no evidence of platelet or coagulation disorder. Author comment: "The hematoma developed spontaneously and occurred following administration of the ozagrel, sulodexide, and nadroparin calcium, which was then immediately discontinued." Fan W-X, et al. Case report: Spontaneous retroperitoneal hemorrhage after hemodialysis involving anticoagulant agents. Journal of Zhejiang University. Science. B 13: 408-412, No. 5, May 2012. Available from: URL: http:// 803076682 dx.doi.org/10.1631/jzus.B1100357 - China
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Reactions 8 Sep 2012 No. 1418
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