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Inadvertent anticoagulation of a haemophiliac child with routine line flushing

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Lambert, Catherine [UCL] Vermylen, Christiane [UCL] Hermans, Cédric [UCL] Deneys, Véronique [UCL] Pothen, D.

We report the case of a 3-year-old boy with severe haemophilia A presenting with recurrent haemarthroses despite daily infusions of factor VIII delivered through a central venous access device (CVAD). Regular rinsing of the CVAD with heparin, according to a standard protocol, resulted in systemic anticoagulation, as demonstrated by prolonged thrombin time and therapeutic anti-Xa levels. The bleeding symptoms resolved after replacing heparin with a normal saline solution. This case illustrates that heparin administered to maintain CVAD patency should be used with caution in young haemophiliacs. Prolonged thrombin time should alert the physician to this possible CVAD complication.

Document type Article de périodique (Journal article) – Case Reports, Journal Article
Access type Accès restreint
Publication date 2006
Language Anglais
Journal information "Haemophilia" - Vol. 12, no. 5, p. 548-50 (2006)
Peer reviewed yes
Publisher Blackwell Publishing (Oxford)
issn 1351-8216
e-issn 1365-2516
Publication status Publié
Affiliations UCL - MD/MINT - Département de médecine interne
UCL - MD/GYPE - Département de gynécologie, d'obstétrique et de pédiatrie
UCL - (SLuc) Centre de malformations vasculaires congénitales
UCL - (SLuc) Service d'hématologie et d'oncologie pédiatrique
UCL - (SLuc) Service d'hématologie
UCL - (MGD) Service d'hématologie
MESH Subject Thrombin Time ; Recurrence ; Male ; Humans ; Heparin - adverse effects ; Hemophilia A - complications - drug therapy ; Hemarthrosis - etiology - prevention & control ; Child, Preschool ; Catheterization, Central Venous - adverse effects ; Anticoagulants - adverse effects
Keywords central venous access device ; haemophilia ; heparin
Links
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Bibliographic reference Lambert, Catherine ; Vermylen, Christiane ; Hermans, Cédric ; Deneys, Véronique ; Pothen, D.. Inadvertent anticoagulation of a haemophiliac child with routine line flushing. In: Haemophilia, Vol. 12, no. 5, p. 548-50 (2006)
Permanent URL http://hdl.handle.net/2078.1/38298