Bleeding diathesis in amyloidosis with renal insufficiency associated with Crohn's disease: response to desmopressin

Am J Gastroenterol. 2002 Jan;97(1):187-9. doi: 10.1111/j.1572-0241.2002.05394.x.

Abstract

A 53-yr-old man with a 33-yr history of Crohn's ileocolitis, complicated by arthritis and cologastric fistulization, was diagnosed with GI amyloidosis at the time of proctocolectomy. He had marked proteinuria (4.2 g/24 h) and moderate renal insufficiency (BUN of 35 mg/dl and serum creatinine of 2.5 mg/dl). During the operation, he had severe bleeding that required 11 U of blood. Postoperatively, desmopressin was administered, which resulted in a prompt cessation of bleeding. This case demonstrates the efficacy of desmopressin in reversing the bleeding diathesis in surgical patients with amyloidosis complicated by renal insufficiency.

Publication types

  • Case Reports

MeSH terms

  • Amyloidosis / complications
  • Amyloidosis / pathology*
  • Blood Transfusion
  • Colectomy / adverse effects
  • Colectomy / methods
  • Crohn Disease / complications
  • Crohn Disease / pathology*
  • Crohn Disease / surgery*
  • Deamino Arginine Vasopressin / administration & dosage*
  • Disease Susceptibility / diagnosis
  • Follow-Up Studies
  • Hemostatics / administration & dosage
  • Humans
  • Intraoperative Complications / diagnosis
  • Intraoperative Complications / therapy
  • Male
  • Middle Aged
  • Postoperative Hemorrhage / diagnosis
  • Postoperative Hemorrhage / drug therapy*
  • Renal Insufficiency / complications
  • Renal Insufficiency / pathology*
  • Treatment Outcome

Substances

  • Hemostatics
  • Deamino Arginine Vasopressin