Modulation of hemostatic balance with antithrombin III replacement therapy in a case of liver cirrhosis associated with recurrent venous thrombosis |
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Authors: | F. Carmassi M. Morale F. De Negri M. Carrai |
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Affiliation: | (1) Istituto di Clinica Medica II, Università di Pisa, Via Roma 67, I-56100 Pisa, Italy;(2) II Divisione Medicina Generale, USL, 12 Pisa, Italy |
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Abstract: | Patients with liver failure can present both thrombotic and hemorragic complications because of the deficiency in coagulation factors and inhibitors (protein C and S, antithrombin III) and impairment of fibrinolytic balance. Here we report the case of a 63-year-old man with liver cirrhosis, recurrent thrombosis, and features of low-grade consumption coagulopathy, showing severe antithrombin III deficiency (about 30% of normal values). Treatment with antithrombin III (2000 U/day) and low doses of heparin (5000 U b.i.d.) was successful in modulating the coagulation system toward an antithrombotic effect. After discharge from hospital the ambulatory treatment with antithrombin III concentrates (2000 U twice a week) allowed the attainment of antithrombin III activity of about 60% and prevented the patient from recurrence of venous thrombosis.Abbreviations AT-III Antithrombin III - DIC Disseminated intravascular coagulation - TAT complexes Thrombin-antithrombin III complexes - PAI-1 Plasminogen activator inhibitor-1 |
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Keywords: | Antithrombin III Liver cirrhosis Venous thrombosis Disseminated intravascular coagulation |
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