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J Pediatr Pharmacol Ther. 2012 Jul;17(3):274-80. doi: 10.5863/1551-6776-17.3.274.

Use of Recombinant Factor VIIa in a Pediatric Patient With Initial Presentation of Refractory Acute Immune Thrombocytopenic Purpura and Severe Bleeding.

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Division of Pediatric Rheumatology, University Hospitals Case Medical Center, Rainbow Babies & Children's Hospital, Cleveland, Ohio.


Severe bleeding in acute immune thrombocytopenic purpura (ITP) is rare but can cause significant complications to the patient. Here we report the case of a pediatric patient with acute ITP and hematuria refractory to anti-D immune globulin, high dose intravenous immunoglobulin G, and high dose steroids. Her hematuria was successfully treated with recombinant factor VIIa (rFVIIa). While further investigation on the use of rFVIIa in ITP is warranted, this case report contributes to the pediatric literature for its use during the course of an initial presentation of ITP with hemorrhagic complications.


FX, factor X; HPF, high-power field; ITP, immune thrombocytopenic purpura; IVIG, intravenous immunoglobulin G; immune thrombocytopenic purpura; pediatrics; rFVIIa, recombinant factor VIIa; recombinant factor VIIa

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