Venous thromboembolism prophylaxis of a patient with MYH-9 related disease and COVID-19 infection:A case report  

作　　者：Bei Jiang Michelle Hartzell Stephen Yu Muhammad Masab Laurel Lyckholm 

机构地区：[1]Department of Hematology and Oncology,West Virginia University,Morgantown,WV 26505,United States [2]Department of Internal Medicine,West Virginia University,Morgantown,WV 26505,United States

出　　处：《World Journal of Hematology》2023年第1期1-8,共8页世界血液学杂志

摘　　要：BACKGROUND The May-Hegglin anomaly is among a group of genetic disorders known as MYH9-related disease.Patients with inherited platelet disorders such as May-Hegglin anomaly are at a variably increased risk for bleeding due to a combination of platelet dysfunction and thrombocytopenia.Patients admitted to the hospital with coronavirus disease 2019(COVID-19)infection are at an increased risk for a venous thromboembolism event(VTE).The National Institutes of Health COVID-19 treatment guidelines recommend using a prophylactic dose of heparin as VTE prophylaxis for adults who are receiving high-flow oxygen.We describe a patient admitted for COVID-19 infection with pneumonia and a history of May-Hegglin anomaly.The patient presented a challenge to determine prophylactic anticoagulation as there are no clear guidelines for this patient population.CASE SUMMARY Herein,we describe the case of a 39-year-old woman admitted with acute hypoxic respiratory failure secondary to COVID-19 pneumonia.She had a history of May-Hegglin anomaly and demonstrated risk for bleeding since childhood,including a life-threatening bleeding event at the age of 9 years requiring blood and platelet transfusions.Her baseline platelet count was 40-50×109/L throughout her adult life.Her family history was also notable for May-Hegglin disorder in her mother,maternal uncle,maternal grandfather and her son.Computed tomography/pulmonary angiography revealed bilateral consolidative opacities consistent with multifocal pneumonia.Complete blood count was notable for platelet count of 54×109/L.She was admitted for inpatient respiratory support with high-flow oxygen per nasal cannula and was managed with guideline-directed therapy for COVID-19,including baricitinib and dexamethasone.The Hematology/Oncology consultation team was requested to assist with management of VTE prophylaxis in the setting of active COVID-19 infection and an inherited bleeding disorder.After review of the literature and careful consideration of risks and benefits,it was decided to t

关 键 词：Venous thromboembolism event PROPHYLAXIS MYH9-related disease Anticoagulation in inherited platelet disorder Low molecular heparin COVID-19 Case report 

分 类 号：R57[医药卫生—消化系统]