老年耶和华见证会信徒肝移植后发生严重急性贫血，接受高剂量促红细胞生成素和羧基麦芽糖铁治疗：一例报告

Severe Acute Anemia After Liver Transplantation in an Elderly Jehovah's Witness Treated With High-dose Erythropoietin and Ferric Carboxymaltose: A Case Report.

作者信息

Brunetta D M, Kaufman J, De Santis G C, Mesquita D F G, Souza F N O A, Garcia J H P

机构信息

Walter Cantidio University Hospital, Federal University of Ceara, Hematology Division, Fortaleza, Ceará, Brazil.

出版信息

Transplant Proc. 2015 Oct;47(8):2548-51. doi: 10.1016/j.transproceed.2015.09.014.

DOI:10.1016/j.transproceed.2015.09.014

PMID:26518969

Abstract

BACKGROUND

There is no standard treatment for patients with severe anemia who refuse blood transfusion or cannot receive red blood cells.

CASE REPORT

After an orthotopic liver transplantation, an elderly Jehovah's Witness who refused blood transfusion presented with severe acute anemia with hemorrhagic shock. The calculated red blood cell loss was near 70%. Associated with surgical treatment and supportive measures, the patient was treated with high-dose erythropoietin and ferric carboxymaltose.

RESULTS

The patient presented a rapid increase in hemoglobin concentration and reticulocyte count with resolution of hemorrhagic shock after the proposed pharmacologic treatment combined with local hemostatic measures. She was transferred to a low-risk unit 4 days after transplantation and was discharged from the hospital on day 10. The hemoglobin concentration was normal 35 days after the bleeding event.

CONCLUSION

This case demonstrated that a protocol with high-dose erythropoietin and ferric carboxymaltose may be an option for patients with severe anemia who refuse blood transfusion or cannot receive red blood cells.

摘要