Satti Tariq Muhammad, Ullah Khalil, Ahmed Parvez, Raza Shahid, Kamal Muhammad Khalid, Chaudhry Qamar-un-Nisa, Akhtar Farrukh Mahmood
Armed Forces Bone Marrow Transplant Centre, Rawalpindi, Pakistan.
J Pak Med Assoc. 2007 Oct;57(10):515-6.
Deep vein thrombosis (DVT) is a rare post transplant multifactorial disease and often results from a combination of risk factors causing venous stasis. Venography and doppler ultrasound are reliable and accurate procedures for detecting venous thrombosis. Once DVT has been established, these patients should be treated with anticoagulants at least for a limited duration particularly in high risk post transplant patients with previous episodes of thrombotic events. We report here a case of a 7 years old boy with B-thalassaemia major, who developed deep vein thrombosis at 04 month post SCT. He was treated with low molecular weight heparin and oral warfarin sodium and INR was stabilized between 2.5 - 3.0. Two months later, he presented with bleeding diathesis and died intracranial haemorrhage. Excessive unchecked anticoagulation was the cause of death. It is recommended that patients on anticoagulation therapy require strict monitoring with PT/INR to avoid bleeding complications related to unchecked over anticoagulation.
深静脉血栓形成（DVT）是一种罕见的移植后多因素疾病，通常由导致静脉淤滞的多种危险因素共同作用引起。静脉造影和多普勒超声是检测静脉血栓形成的可靠且准确的方法。一旦确诊为DVT，这些患者应接受抗凝治疗，至少在有限的时间内进行治疗，特别是对于既往有血栓形成事件发作的高风险移植后患者。我们在此报告一例7岁重型β地中海贫血男孩，他在异基因造血干细胞移植后4个月发生了深静脉血栓形成。他接受了低分子量肝素和口服华法林钠治疗，国际标准化比值（INR）稳定在2.5至3.0之间。两个月后，他出现出血倾向并死于颅内出血。抗凝过度且未加控制是死亡原因。建议接受抗凝治疗的患者通过凝血酶原时间/国际标准化比值（PT/INR）进行严格监测，以避免因抗凝过度且未加控制而导致的出血并发症。
