Successful use of N-acetyl cysteine and activated recombinant factor VII in fulminant hepatic failure and massive bleeding secondary to dengue hemorrhagic fever
Consensus on management of complicated cases of dengue infection is evolving. Dengue hemorrhagic fever (DHF) occasionally progress to fulminant liver failure with high fatality rate. Inadvertent use of blood products to control massive bleeding in dengue shock syndrome may worsen fluid overload and...
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Wolters Kluwer Medknow Publications
2014-01-01
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doaj-9e6ff45562864ad3b91d32688b3fc54e2020-11-24T22:30:33ZengWolters Kluwer Medknow PublicationsJournal of Emergencies, Trauma and Shock0974-27002014-01-017431331510.4103/0974-2700.142771Successful use of N-acetyl cysteine and activated recombinant factor VII in fulminant hepatic failure and massive bleeding secondary to dengue hemorrhagic feverEdirisooriya Maddumage ManojGayan RanasingheMK RagunathanConsensus on management of complicated cases of dengue infection is evolving. Dengue hemorrhagic fever (DHF) occasionally progress to fulminant liver failure with high fatality rate. Inadvertent use of blood products to control massive bleeding in dengue shock syndrome may worsen fluid overload and subsequently the multi-organ dysfunction. We report a case of 37-years-old Sri Lankan man who developed fulminant liver failure and massive bleeding associated with DHF, subsequently recovered completely with supportive measures including administration of N-acetyl cysteine and activated recombinant factor VII. In conclusion, prevention of ischemic injury to liver and adoption of early aggressive supportive measures in complicated cases of dengue hemorrhagic fever is crucial for a favorable outcome. Indications for rFVIIa to arrest uncontrolled internal bleeding and use of NAC in non-acetaminophen-induced acute liver failure in complicated DHF are a platform for discussion.http://www.onlinejets.org/article.asp?issn=0974-2700;year=2014;volume=7;issue=4;spage=313;epage=315;aulast=ManojActivated recombinant factor VIIdenguefulminant hepatic failureN-acetyl cysteine |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Edirisooriya Maddumage Manoj Gayan Ranasinghe MK Ragunathan |
spellingShingle |
Edirisooriya Maddumage Manoj Gayan Ranasinghe MK Ragunathan Successful use of N-acetyl cysteine and activated recombinant factor VII in fulminant hepatic failure and massive bleeding secondary to dengue hemorrhagic fever Journal of Emergencies, Trauma and Shock Activated recombinant factor VII dengue fulminant hepatic failure N-acetyl cysteine |
author_facet |
Edirisooriya Maddumage Manoj Gayan Ranasinghe MK Ragunathan |
author_sort |
Edirisooriya Maddumage Manoj |
title |
Successful use of N-acetyl cysteine and activated recombinant factor VII in fulminant hepatic failure and massive bleeding secondary to dengue hemorrhagic fever |
title_short |
Successful use of N-acetyl cysteine and activated recombinant factor VII in fulminant hepatic failure and massive bleeding secondary to dengue hemorrhagic fever |
title_full |
Successful use of N-acetyl cysteine and activated recombinant factor VII in fulminant hepatic failure and massive bleeding secondary to dengue hemorrhagic fever |
title_fullStr |
Successful use of N-acetyl cysteine and activated recombinant factor VII in fulminant hepatic failure and massive bleeding secondary to dengue hemorrhagic fever |
title_full_unstemmed |
Successful use of N-acetyl cysteine and activated recombinant factor VII in fulminant hepatic failure and massive bleeding secondary to dengue hemorrhagic fever |
title_sort |
successful use of n-acetyl cysteine and activated recombinant factor vii in fulminant hepatic failure and massive bleeding secondary to dengue hemorrhagic fever |
publisher |
Wolters Kluwer Medknow Publications |
series |
Journal of Emergencies, Trauma and Shock |
issn |
0974-2700 |
publishDate |
2014-01-01 |
description |
Consensus on management of complicated cases of dengue infection is evolving. Dengue hemorrhagic fever (DHF) occasionally progress to fulminant liver failure with high fatality rate. Inadvertent use of blood products to control massive bleeding in dengue shock syndrome may worsen fluid overload and subsequently the multi-organ dysfunction. We report a case of 37-years-old Sri Lankan man who developed fulminant liver failure and massive bleeding associated with DHF, subsequently recovered completely with supportive measures including administration of N-acetyl cysteine and activated recombinant factor VII. In conclusion, prevention of ischemic injury to liver and adoption of early aggressive supportive measures in complicated cases of dengue hemorrhagic fever is crucial for a favorable outcome. Indications for rFVIIa to arrest uncontrolled internal bleeding and use of NAC in non-acetaminophen-induced acute liver failure in complicated DHF are a platform for discussion. |
topic |
Activated recombinant factor VII dengue fulminant hepatic failure N-acetyl cysteine |
url |
http://www.onlinejets.org/article.asp?issn=0974-2700;year=2014;volume=7;issue=4;spage=313;epage=315;aulast=Manoj |
work_keys_str_mv |
AT edirisooriyamaddumagemanoj successfuluseofnacetylcysteineandactivatedrecombinantfactorviiinfulminanthepaticfailureandmassivebleedingsecondarytodenguehemorrhagicfever AT gayanranasinghe successfuluseofnacetylcysteineandactivatedrecombinantfactorviiinfulminanthepaticfailureandmassivebleedingsecondarytodenguehemorrhagicfever AT mkragunathan successfuluseofnacetylcysteineandactivatedrecombinantfactorviiinfulminanthepaticfailureandmassivebleedingsecondarytodenguehemorrhagicfever |
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