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Consumptive coagulopathy complicating juvenile angiofibroma
Campbell Baguley1, Guri Sandhu, James O'Donnell
1Royal National Throat, Nose and Ear Hospital, London, UK.
Objective:
To investigate the incidence and clinical significance of deranged clotting results among patients with juvenile (nasopharyngeal) angiofibroma.
Methods:
Twenty consecutive patients treated for juvenile angiofibroma between March 1998 and July 2002 in whom preoperative coagulation tests were performed were selected. Results were compared with normal laboratory values, and clinical and histological records were retrospectively analysed.
Results:
Four out of 20 patients were found to have abnormal tests, consistent with concurrent consumptive coagulopathies. One patient was found to have a raised D-dimer level. This resolved following removal of the lesion.
Conclusions:
The association between larger arterio-venous malformations and disseminated intravascular coagulopathy is well described (Kasabach-Merritt syndrome). Our findings suggest that low-grade consumptive coagulopathies may also complicate smaller juvenile angiofibromas, implying that preoperative coagulation screening tests may have a role in ensuring optimal perioperative haemostasis.