Abstract
Venous thromboembolism occurs in 48–200 out of 1,000 patients with brain cancer per year, which is significantly more frequent than in general population.Case report. A female patient had surgical treatment of anaplastic astrocytoma following radiotherapy and chemotherapy (temozolomide, irinotecan, bevacizumab) at the age of 17 years old. She also received dexamethasone. At the age of 20 years, she developed cancer recurrence, that required chemotherapy. After chemotherapy had been initiated, the patient developed deep vein thrombosis of the legs. Rivaroxaban 20 mg/d for 2.5 months with the subsequent switch to enoxaparin 60 mg/d showed no recanalization. Enoxaparin dose increasing up to 160 mg/d demonstrated incomplete recanalization, however, superficial venous thrombosis of the legs developed. Combination therapy with enoxaparin plus warfarin resulted in further deep and superficial veins recanalization.Discussion. In cancer-associated venous thromboembolism that is resistant to low molecular weight heparin monotherapy, short-term combination therapy with low molecular weight heparin and vitamin K antagonists can be considered. However, in recurrent cancer standard treatment protocols can be ineffective.
Highlights
Gilyarov monitored and treated the patient when she had been hospitalized in Moscow City Clinical Hospital No 1 named after N.I
(Medicine), Professor, Department of Cardiology, Functional and Ultrasound Diagnostics, Sechenov First Moscow State Medical University (Sechenov University); Deputy Hospital Chief Physician (Therapy) of Moscow City Clinical Hospital No 1 named after N.I. Pirogov
Summary
В 20 лет развился рецидив опухоли, потребовавший проведения химиотерапии, состояние осложнилось развитием тромбоза глубоких вен нижних конечностей. Комбинированная терапия эноксапарином и варфарином привела к дальнейшей реканализации тромбов глубоких и поверхностных вен нижних конечностей. Ключевые слова: анапластическая астроцитома; ривароксабан; эноксапарин; антикоагулянты; низкомолекулярный гепарин; варфарин; химиолучевая терапия; тромбоз глубоких вен нижних конечностей Рубрики MeSH: ЧЕЛОВЕК ЖЕНСКИЙ ОПИСАНИЕ СЛУЧАЕВ АСТРОЦИТОМА – ТЕРАПИЯ АСТРОЦИТОМА – ОСЛОЖНЕНИЯ ТРОМБОЗ ВЕНОЗНЫЙ – ТЕРАПИЯ ТРОМБОЗ ВЕНОЗНЫЙ – ЭТИОЛОГИЯ КОНЕЧНОСТЬ НИЖНЯЯ – КРОВОСНАБЖЕНИЕ КОМБИНИРОВАННОЕ ЛЕЧЕБНОЕ ВОЗДЕЙСТВИЕ Для цитирования: Павлова М.Г., Амергулов И.И., Лиходей Н.В., Куркина И.А., Глинкина И.В., Желудкова О.Г., Гиляров М.Ю. Проблемы профилактики и лечения тромбоэмболических осложнений у пациента с анапластической астроцитомой: описание клинического случая. СЕЧЕНОВСКИЙ ВЕСТНИК Т. 12, No 1, 2021 / SECHENOV MEDICAL JOURNAL VOL. 12, No 1, 2021
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