Open AccessParadoxical pulmonary hemorrhage associated with hemocoagulase batroxobin in a patient with hemoptysis
Author(s) -
Tae-Ok Kim,
Minsuk Kim,
Bo Gun Kho,
Ha Young Park,
Yong-Soo Kwon,
Yu-Il Kim,
SungChul Lim,
Hyeonsook Shin
Publication year - 2021
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000024040
Subject(s) - medicine , batroxobin , hypofibrinogenemia , ecchymosis , surgery , gastrointestinal bleeding , pulmonary hemorrhage , fibrinogen , organophosphate poisoning , anesthesia , lung , organophosphate , agronomy , pesticide , biology
Rational: Hemocoagulase, a hemostatic, is used in patients with trauma, gastrointestinal bleeding, or pulmonary hemorrhage or those undergoing surgery. However, paradoxical bleeding after hemocoagulase administration is not considered a clinically significant adverse effect. Here, we report a case of paradoxical pulmonary hemorrhage associated with hypofibrinogenemia after administration of the hemocoagulase batroxobin in a patient with hemoptysis. Patient concerns: An 86-year-old woman complained of hemoptysis during hospitalization with organophosphate poisoning. Hemocoagulase was administered to manage bleeding; however, bleeding signs, such as hemoptysis, massive epistaxis, and ecchymosis, recurred. Diagnoses: The patient was diagnosed with acquired hypofibrinogenemia on the basis of the reduced plasma fibrinogen level after hemocoagulase administration and lack of other causes of bleeding. Intervention: Hemocoagulase administration was discontinued, and fibrinogen-containing plasma products were administered. Outcomes: The plasma fibrinogen level normalized and bleeding signs did not recur. Lessons: It is necessary to measure plasma fibrinogen levels regularly in patients undergoing hemocoagulase administration and discontinue its administration when acquired hypofibrinogenemia is detected.