BACKGROUND The contradictory process of coagulation and anticoagulation maintains normal physiological function,and platelets(PLTs)play a key role in hemostasis and bleeding.When severe thrombocytopenia and deep vein ...BACKGROUND The contradictory process of coagulation and anticoagulation maintains normal physiological function,and platelets(PLTs)play a key role in hemostasis and bleeding.When severe thrombocytopenia and deep vein thrombosis(DVT)occur simultaneously,the physician will be confronted with a great challenge,especially when interventional thrombectomy fails.CASE SUMMARY We describe a 52-year-old woman who suffered from myelodysplastic syndrome with severe thrombocytopenia and protein S deficiency with right lower extremity DVT.In this patient,the treatment of DVT was associated with numerous contradictions due to severe thrombocytopenia,especially when interventional thrombectomy was not successful.Fortunately,fondaparinux sodium effectively alleviated the thrombus status of the patient and gradually decreased the D-dimer level.In addition,no increase in bleeding was noted.The application of eltrombopag stimulated the maturation and differentiation of megakaryocytes and increased the peripheral blood PLT count.The clinical symptoms of DVT in the right lower extremities in this patient significantly improved.The patient resumed daily life activities,and the treatment effects were independent of PLT transfusion.CONCLUSION This is a contradictory and complex case,and fondaparinux sodium and eltrombopag may represent a good choice for the treatment of DVT in patients with severe thrombocytopenia.展开更多
基金Supported by the Zhejiang Province Administration of Traditional Chinese Medicine,No.2017ZB034 and No.2020ZB096the Zhejiang University of Traditional Chinese Medicine School-Level Fund,No.2019ZG06the National Nonprofit Institute Research Grant for Institute of Basic Theory for Chinese Medicine,CACMS,No.YZ-202142.
文摘BACKGROUND The contradictory process of coagulation and anticoagulation maintains normal physiological function,and platelets(PLTs)play a key role in hemostasis and bleeding.When severe thrombocytopenia and deep vein thrombosis(DVT)occur simultaneously,the physician will be confronted with a great challenge,especially when interventional thrombectomy fails.CASE SUMMARY We describe a 52-year-old woman who suffered from myelodysplastic syndrome with severe thrombocytopenia and protein S deficiency with right lower extremity DVT.In this patient,the treatment of DVT was associated with numerous contradictions due to severe thrombocytopenia,especially when interventional thrombectomy was not successful.Fortunately,fondaparinux sodium effectively alleviated the thrombus status of the patient and gradually decreased the D-dimer level.In addition,no increase in bleeding was noted.The application of eltrombopag stimulated the maturation and differentiation of megakaryocytes and increased the peripheral blood PLT count.The clinical symptoms of DVT in the right lower extremities in this patient significantly improved.The patient resumed daily life activities,and the treatment effects were independent of PLT transfusion.CONCLUSION This is a contradictory and complex case,and fondaparinux sodium and eltrombopag may represent a good choice for the treatment of DVT in patients with severe thrombocytopenia.
