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Prothrombin complex concentrate

R T DeWitt, D I Feinstein

    Archives of Internal Medicine
    |September 1, 1977
    PubMed
    Summary
    This summary is machine-generated.

    Prothrombin complex concentrate effectively stopped massive bleeding in a hemophiliac patient with a factor VIII inhibitor. This treatment allowed the surgical wound to heal, bypassing the need for factor VIII activity.

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    Area of Science:

    • Hematology
    • Coagulation Disorders
    • Pharmacology

    Background:

    • Hemophilia A is a genetic bleeding disorder characterized by deficient Factor VIII activity.
    • Factor VIII inhibitors complicate hemophilia treatment, rendering standard replacement therapy ineffective.
    • Massive surgical bleeding poses a significant challenge in patients with hemophilia and inhibitors.

    Observation:

    • A hemophiliac patient with a Factor VIII inhibitor experienced life-threatening bleeding from a surgical wound.
    • Conservative management strategies failed to control the hemorrhage over a ten-day period.
    • A single infusion of prothrombin complex concentrate (Konyne) was administered.

    Findings:

    • The prothrombin complex concentrate infusion immediately ceased the massive bleeding.

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  • The surgical wound healed successfully without any further bleeding episodes.
  • While activated partial thromboplastin time improved, the precise mechanism of bypassing Factor VIII remains unclear.

    • Implications:

    • Prothrombin complex concentrates offer a viable alternative for managing bleeding in hemophiliacs with Factor VIII inhibitors.
    • Further research is warranted to elucidate the exact physiological mechanism of action for these concentrates.
    • This case highlights the potential of bypassing agents in critical bleeding situations.