Inadvertent anticoagulation of a haemophiliac child with routine line flushing

Haemophilia. 2006 Sep;12(5):548-50. doi: 10.1111/j.1365-2516.2006.01294.x.

Abstract

We report the case of a 3-year-old boy with severe haemophilia A presenting with recurrent haemarthroses despite daily infusions of factor VIII delivered through a central venous access device (CVAD). Regular rinsing of the CVAD with heparin, according to a standard protocol, resulted in systemic anticoagulation, as demonstrated by prolonged thrombin time and therapeutic anti-Xa levels. The bleeding symptoms resolved after replacing heparin with a normal saline solution. This case illustrates that heparin administered to maintain CVAD patency should be used with caution in young haemophiliacs. Prolonged thrombin time should alert the physician to this possible CVAD complication.

Publication types

  • Case Reports

MeSH terms

  • Anticoagulants / adverse effects*
  • Catheterization, Central Venous / adverse effects*
  • Child, Preschool
  • Hemarthrosis / etiology
  • Hemarthrosis / prevention & control
  • Hemophilia A / complications
  • Hemophilia A / drug therapy*
  • Heparin / adverse effects*
  • Humans
  • Male
  • Recurrence
  • Thrombin Time

Substances

  • Anticoagulants
  • Heparin