儿童急性髓系白血病合并右股静脉和右背动脉血栓形成：1 例报告。
Right femoral vein and right dorsal artery thrombosis in childhood acute myeloid leukemia: A case report.
机构信息
Department of Pharmacy/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China.
Key Laboratory of Birth Defects & Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.
出版信息
Medicine (Baltimore). 2023 Oct 13;102(41):e35121. doi: 10.1097/MD.0000000000035121.
BACKGROUND
It is rare for newly diagnosed (de novo) or newly treated acute myeloid leukemia (AML) complicated with thrombotic complications, especially combined arterial and venous thrombosis.
METHODS
We reported a 13-year-old boy diagnosed with AML and leukocytosis, who developed right femoral vein and right dorsal artery thrombosis during chemotherapy. After treatment with low molecular weight heparin, diosmin, and alprostadil, symptoms were relieved. Unfortunately, the child suffered from coagulopathy afterward, which was unexpectedly caused by vitamin K deficiency.
RESULTS
After supplementation with vitamin K and prothrombin complex concentrate, coagulation function recovered.
CONCLUSION
For childhood AML patients with high thrombotic risks, close monitoring during anticoagulant treatment was necessary. Concomitantly, we should be alert to past medication history and combined medication use, especially those that may lead to vitamin K deficiency, secondary bleeding, and coagulation disorders. Rational use of antibiotics, anticoagulants, and antitumor drugs must be guaranteed.
背景
新诊断（de novo）或新治疗的急性髓系白血病（AML）合并血栓并发症较为罕见，尤其是合并动脉和静脉血栓。
方法
我们报告了一例 13 岁男孩，诊断为 AML 和白细胞增多，在化疗期间发生右股静脉和右背动脉血栓形成。给予低分子肝素、地奥司明和前列地尔后，症状缓解。不幸的是，患儿随后出现凝血功能障碍，出乎意料的是由维生素 K 缺乏引起。
结果
补充维生素 K 和凝血酶原复合物浓缩物后，凝血功能恢复。
结论
对于具有高血栓风险的儿童 AML 患者，在抗凝治疗期间需要密切监测。同时，我们应该警惕既往用药史和联合用药，尤其是可能导致维生素 K 缺乏、继发出血和凝血障碍的药物。必须保证合理使用抗生素、抗凝剂和抗肿瘤药物。
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