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Case Reports in Hematology
Volume 2014 (2014), Article ID 283086, 3 pages
http://dx.doi.org/10.1155/2014/283086
Case Report

Failure of Recombinant Activated Factor VII in Treatment of Diffuse Alveolar Hemorrhage due to Cryoglobulinemic Vasculitis

1Department of Internal Medicine, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI 48202, USA
2Department of Internal Medicine, Division of Hospital Medicine, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI 48202, USA
3Division of Hematology and Oncology, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI 48202, USA
4Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI 48202, USA
5Division of Nephrology and Hypertension, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI 48202, USA

Received 2 May 2014; Accepted 28 June 2014; Published 10 July 2014

Academic Editor: Panagiotis Tsirigotis

Copyright © 2014 Dania Khoulani et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Diffuse alveolar hemorrhage (DAH) is a serious complication of the small vessel vasculitis syndromes and carries a high mortality. Recombinant activated factor VII (rFVIIa) is used to treat bleeding in patients with hemophilia and antibodies to factor VIII or IX. It is increasingly being used in life-threatening hemorrhage in a variety of other settings in which conventional therapy is unsuccessful. Randomized controlled trials of rFVIIa in DAH are lacking. However, several case reports have described a complete or sustained control of DAH using rFVIIa after patients failed to respond to medical treatment. There are no case reports in the literature describing the use or the failure of rFVIIa in DAH associated with cryoglobulinemic vasculitis. We here report the failure of rFVIIa to control DAH in a patient with CD5+ B-cell non-Hodgkin’s lymphoma and cryoglobulinemic vasculitis.