RESUMO
Long-term dialysis is undertaken infrequently in patients with hemophilia and chronic renal failure, and there are no definite guidelines for the treatment of end-stage renal disease in hemophiliacs. We report a case of peritoneal dialysis in a hemophiliac with diabetic chronic renal failure. A 46-year-old man with severe hemophilia was admitted to our hospital for decreased visual acuity and the management of uremia. After vitrectomy, he was started on hemodialysis to treat his uremic bleeding diathesis. To avoid bleeding through a vascular access site, peritoneal dialysis therapy for long-term treatment was proposed. A surgical peritoneal catheter was introduced with simultaneous factor VIII administration. In the seven subsequent months, no episodes of intraperitoneal or retroperitoneal hemorrhage have been observed. Continuous ambulatory peritoneal dialysis may be a relatively safe dialysis modality without danger of bleeding in hemophiliacs.
Assuntos
Humanos , Pessoa de Meia-Idade , Catéteres , Diálise , Suscetibilidade a Doenças , Fator VIII , Hemofilia A , Hemorragia , Falência Renal Crônica , Diálise Peritoneal , Diálise Peritoneal Ambulatorial Contínua , Diálise Renal , Uremia , Acuidade Visual , VitrectomiaRESUMO
Kasabach-Merritt phenomenon does not occur with common hemangioma, rather it is associated with the more aggressive Kaposiform hemangioendothelioma and rarely with other vascular neoplasm. We report the case of an adult who was diagnosed as Kaposiform hemangioendothelioma complicated by Kasabach-Memtt phenomenon. This is the first report in Korea of an adult with Kasabach-Merritt phenomenon who has osteolytic changes of femur, pelvic bone, and lumbar spine.