Tranexamic Acid Use for Massive Hemoptysis in a Child: A Case Report

Area of Science:

• Pediatric Pulmonology
• Critical Care Medicine
• Pharmacology

Background:

• Massive hemoptysis is a rare but serious condition in children, often necessitating invasive interventions.
• Current therapeutic guidelines for massive hemoptysis in pediatric non-cystic fibrosis bronchiectasis are limited and primarily extrapolated from adult data or cystic fibrosis cases.
• Standard treatments include bronchoscopy, embolization, and surgery, with tranexamic acid (TXA) typically reserved for non-massive bleeding or as a temporary measure.

Observation:

• A 10-year-old boy with non-cystic fibrosis bronchiectasis experienced massive hemoptysis.
• Systemic administration of tranexamic acid (TXA) was initiated as an emergency treatment.
• The patient responded promptly to TXA, with bleeding cessation after the first dose, averting the need for invasive procedures.

Findings:

• Systemic TXA effectively controlled massive hemoptysis in a pediatric patient with non-cystic fibrosis bronchiectasis.
• Despite a subsequent episode of hemoptysis due to pneumonia, TXA again proved effective, preventing invasive interventions.
• No recurrence of hemoptysis was observed during a two-year follow-up after TXA cessation.

Implications:

• Tranexamic acid (TXA) shows potential as a non-invasive, first-line emergency treatment for massive hemoptysis in children, particularly when invasive options are unavailable or contraindicated.
• This case highlights the possible utility of TXA in managing severe bleeding episodes in pediatric patients with chronic lung conditions.
• Further research is warranted to establish the efficacy and safety of systemic TXA for massive hemoptysis in pediatric populations.