Tenecteplase
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Bleeding and haematoma: case report A 65-year-old woman developed bleeding and haematoma following treatment with tenecteplase for pulmonary thromboembolism. The woman presented with chest pain and shortness of breath to the emergency department. Following various investigations, she was considered to have high-risk pulmonary thromboembolism, and she was admitted in the ICU. However, a cardiac arrest occurred immediately after her admission. She was administered off label tenecteplase [route and dosage not stated], which was present in the coronary intensive care unit. She was estimated to weigh around 90-100kg and was administered at a dose of 50mg = 10mL. Resuscitation was continued, and she returned to the sinus rhythm after a while. She was started with low molecular weight heparin (LMWH) treatment during follow-up. She developed haematoma in the area where coronary angiography was done. Her haemoglobin was found to be decreased. The woman underwent erythrocyte replacement. Her bleeding stopped and saturation was found to be increased to 99%, hence she was taken to the regular care unit. One more unit of erythrocyte was replaced in the regular care unit. She was commenced with warfarin. INR was between 2 and 3 and no additional problems were found. She was discharged on foot after a total duration of 1 week. During her control, thrombosis was observed in the left popliteal vein on lower extremity. Creatinine returned to normal and spiral thorax CT angiography confirmed her complete recovery. Warfarin was continued as follow-up treatment. Yilmaz YA, et al. A Case of Massive Pulmonory Thromboembolism in Cardiac Arrest and Tenecteplase Use. [Turkish]. Respiratory Case Reports 9: 60-65, No. 2, Jun 2020. 803498167 Available from: URL: http://doi.org/10.5505/respircase.2020.01328 [Turkish; summarized from a translation]
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Reactions 29 Aug 2020 No. 1819
