A case of subdural hematoma in patient with chronic myeloid leukemia treated with high-dose imatinib mesylate.

A case of subdural hematoma in patient with chronic myeloid leukemia treated with high-dose imatinib mesylate.

Korean J Hematol. 2010 Mar;45(1):73-5

Authors: Kim MS, Lee DH, Lee YR, Kim DK, Bae SH, Hwang JY, Kwon KA, Lee S, Han JY, Kim KU, Kim SH

Imatinib mesylate (IM) is used to treat a wide range of diseases, including Philadelphia chromosome-positive chronic myeloid leukemia (CML), on account of its high tolerability and low incidence of minor adverse events. Hemorrhage is thought to be a rare complication of IM. Recently, IM has been associated with reduced α2-plasmin inhibitor and platelet dysfunction. We report here the case of a 33-year-old female patient with CML who experienced subdural hematoma after an incremental increase in IM dosage due to a loss of complete molecular response. This case indicates that physicians should be alert to this atypical cause of headache in patients taking high-dose IM.

PMID: 21120168 [PubMed - in process]

Acquired factor VIII deficiency after consuming the dried gallbladder of a cobra, Naja naja.

Acquired factor VIII deficiency after consuming the dried gallbladder of a cobra, Naja naja.

Korean J Hematol. 2010 Sep;45(3):205-7

Authors: Kim HJ, Lee WS, Lee YJ, Jun HS, Seo SK, Joo YD

Acquired factor VIII deficiency is very rare, often fatal. It is associated with pregnancy, autoimmune diseases, malignancy, and drugs, although no underlying cause is found in 50%. A 49-year-old male was referred with right shoulder bruising. The coagulation test showed a prolonged activated partial thromboplastin time. The factor VIII level was less than 1%, and the factor VIII inhibitor antibody titer was 246 Bethesda units/mL. The findings were compatible with acquired factor VIII deficiency. He had consumed the dried gallbladder of a cobra, Naja naja, for two weeks, it contained venom. After the initial treatment with factor VIII, he did not take supplemental coagulation factor VIII. The patient was readmitted with left forearm swelling. He lost consciousness suddenly and brain computed tomography (CT) revealed a subdural hematoma. Despite administering recombinant factor VII, his bleeding was not controlled and he died.

PMID: 21120211 [PubMed - in process]