Tranexamic Acid Inhalation for Severe Hemoptysis in a Patient with Lung Cancer and Deep Venous Thrombosis

Abstract

Background: Hemoptysis is a common clinical symptom in patients with lung cancer. Intravenous or oral tranexamic acid (TA) is frequently used to treat. However, systemic TA is not appropriate in some cases with potential contraindications such as vascular occlusive events. Case report: We here report a case of lung cancer with severe hemoptysis and deep venous thrombosis (DVT). He initially received low-molecular-weight heparins subcutaneously and shifted to oral warfarin for DVT. However, after few days of anticoagulant, he suffered from severe hemoptysis. Warfarin was discontinued and the patient was prescribed intravenous TA. The hemoptysis still persisted and DVT progressed after TA and discontinuation. In order to manage the dilemma of coexisting hemoptysis and DVT, we provided inhaled TA for hemoptysis and enoxaparin subcutaneously twice daily for DVT. The hemoptysis subsided soon after inhaled TA. His DVT also gradually improved after enoxaparin treatment. Conclusion: Inhaled TA is effective in severe hemoptysis and is not contraindicated in patients with DVT. We suggest utilizing this treatment strategy in patients with both hemoptysis and contraindication for systemic TA.