RESUMO
Factor VIII:C, epsilon amino-caproic acid or tranexamic acid are prophylactic agents used in preventing hemorrhage pre-operatively in patients with hemophilia A. Although hemophilia A seems to be a factor that avoids the development of acute myocardial infarction (AMI) as it tends to be associated with increased bleeding, it should be kept in mind that prothrombotic agents used pre-operatively for prophylaxis may increase the risk for AMI in the presence of the factor V Leiden mutation. In this report, we discuss the development of AMI following the use of recombinant factor VIII and tranexamic acid for prophylaxis in a patient with known hemophilia before a tooth extraction in conjunction with the relevant literature.
Assuntos
Antifibrinolíticos/efeitos adversos , Perda Sanguínea Cirúrgica/prevenção & controle , Coagulantes/efeitos adversos , Fator VIII/efeitos adversos , Fator V , Hemofilia A/tratamento farmacológico , Infarto do Miocárdio/etiologia , Extração Dentária/efeitos adversos , Ácido Tranexâmico/efeitos adversos , Angioplastia Coronária com Balão/instrumentação , Angiografia Coronária , Estenose Coronária/complicações , Estenose Coronária/diagnóstico , Estenose Coronária/terapia , Hemofilia A/complicações , Hemofilia A/genética , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Infarto do Miocárdio/induzido quimicamente , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/genética , Infarto do Miocárdio/terapia , Proteínas Recombinantes/efeitos adversos , Fatores de Risco , Fumar/efeitos adversos , StentsRESUMO
Thalidomide is successfully used in the treatment of multiple myeloma, leprosy and various autoimmune diseases due to its anti-angiogenic, immunomodulatory and anti-inflammatory effects. Thalidomide's most common side effects are constipation, neuropathy, fatigue, sedation, rash, tremor and peripheral edema. We achieved complete response with a 400 mg/day dose thalidomide therapy in a 58-year-old male patient diagnosed with relapsing refractory multiple myeloma. While continuing thalidomide for sustainable response, the therapy was terminated at the ninth month due to development of leukocytoclastic vasculitis. We describe the case and discuss the place of thalidomide in the treatment of multiple myeloma and the rare occurrence of leukocytoclastic vasculitis during thalidomide therapy in multiple myeloma, since only one such case has been reported in the literature thus far.
