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Effective anticoagulation by argatroban during immunoadsorption therapy for malignant rheumatoid arthritis with a
S Suzuki1, S Sakamoto, M Koide
1Department of Internal Medicine, Hyogo Prefectural Awaji Hospital, Japan.
Abstract:
Polymorphonuclear leukocyte elastase (PMNE) is a glycoprotein with a molecular weight of about 30000 and exists in 3 isozymes (1). It has a biological role in host defense mechanisms, but it sometimes induces abnormal blood coagulation and injury of the vascular intima (1,2). We were not able to obtain a satisfactory anticoagulant effect when using heparin during immunoadsorption therapy in a patient with malignant rheumatoid arthritis and high PMNE level, but found that argatroban, a selective antithrombin agent, produced satisfactory anticoagulation. This finding is interesting as far as the various pathologic roles of PMNE are attracting increasing clinical attention (1,2,3).