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Case Reports
. 2017;89(7):76-84.
doi: 10.17116/terarkh201789776-84.

[Thrombotic events in patients with hemophilia]

[Article in Russian]
Affiliations
Case Reports

[Thrombotic events in patients with hemophilia]

[Article in Russian]
G M Galstyan et al. Ter Arkh. 2017.

Abstract

The paper describes 4 clinical cases of thrombotic events (pulmonary embolism, deep vein thrombophlebitis, acute myocardial infarction, ischemic stroke) that have occurred in patients with hemophilia. It discusses the possible causes of their development and methods for their prevention and treatment. Controlled natural hypocoagulation, in which the dose of an administered deficient factor decreases to such an extent that in order to maintain the safe level of hypocoagulation (plasma factor activity is 15-20%; activated partial thromboplastin time is 1.5-2 times normal values), is proposed as one of the treatment options.

Приводятся 4 клинических наблюдения тромботических осложнений (тромбоэмболия легочной артерии, тромбофлебит глубоких вен, острый инфаркт миокарда, ишемический инсульт), возникших у больных гемофилией. Обсуждаются возможные причины их развития, методы профилактики и лечения. В качестве одного из методов лечения предлагается управляемая естественная гипокоагуляция, при которой доза вводимого дефицитного фактора уменьшается до такой степени, чтобы поддерживать у больного безопасный уровень гипокоагуляции (плазменная активность фактора 15-20%, активированное частичное тромбопластиновое время в 1,5-2 раза больше нормы).

Keywords: coagulation factor IX; coagulation factor VIII; deep vein thrombosis; hemophilia; hypocoagulation; ischemic stroke; myocardial infarction; pulmonary embolism; thromboelastography; thrombophilia.

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