Paradoxical pulmonary hemorrhage associated with hemocoagulase batroxobin in a patient with hemoptysis: A CARE-compliant case report.

Journal: Medicine
Treatment Used: Hemocoagulase Discontinuation and Fibrinogen-Containing Plasma Administration
Number of Patients: 1
MediFind Summary

Summary: This case report describes a hemoptysis patient that experienced a paradoxical pulmonary hemorrhage that was associated with hemocoagulase batroxobin administration.

Conclusion: The report states that, after hemocoagulase discontinuation and administration of fibrinogen-containing plasma, the patients plasma fibrinogen levels normalized and their bleeding signs did not recur.


Background: Hemocoagulase, 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.

Methods: An 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. Methods: The 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. Methods: Hemocoagulase administration was discontinued, and fibrinogen-containing plasma products were administered.

Results: The plasma fibrinogen level normalized and bleeding signs did not recur.

Conclusions: It is necessary to measure plasma fibrinogen levels regularly in patients undergoing hemocoagulase administration and discontinue its administration when acquired hypofibrinogenemia is detected.

Tae-ok Kim, Min-suk Kim, Bo Kho, Ha Park, Yong-soo Kwon, Yu-il Kim, Sung-chul Lim, Hong-joon Shin

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