• Tae-Ok Kim, Min-Suk Kim, Bo Gun Kho, Ha Young Park, Yong-Soo Kwon, Yu-Il Kim, Sung-Chul Lim, and Hong-Joon Shin.
• Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea.
• Medicine (Baltimore). 2021 Jan 29; 100 (4): e24040e24040.

RationalHemocoagulase, a hemostatic, is used in patients with trauma, gastrointestinal bleeding, or pulmonary hemorrhage or those undergoing surgery. However, paradoxical bleeding after hemocoagulase administration is not considered a clinically significant adverse effect. Here, we report a case of paradoxical pulmonary hemorrhage associated with hypofibrinogenemia after administration of the hemocoagulase batroxobin in a patient with hemoptysis.Patient ConcernsAn 86-year-old woman complained of hemoptysis during hospitalization with organophosphate poisoning. Hemocoagulase was administered to manage bleeding; however, bleeding signs, such as hemoptysis, massive epistaxis, and ecchymosis, recurred.DiagnosesThe patient was diagnosed with acquired hypofibrinogenemia on the basis of the reduced plasma fibrinogen level after hemocoagulase administration and lack of other causes of bleeding.InterventionHemocoagulase administration was discontinued, and fibrinogen-containing plasma products were administered.OutcomesThe plasma fibrinogen level normalized and bleeding signs did not recur.LessonsIt is necessary to measure plasma fibrinogen levels regularly in patients undergoing hemocoagulase administration and discontinue its administration when acquired hypofibrinogenemia is detected.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

26 keywords...

hide…