phenprocoumon and Hemoglobinuria--Paroxysmal

A 67-year-old lady was admitted with a myocardial infarction. Coronarography revealed thrombotic material within coronary arteries. The underlying disease was paroxysmal nocturnal hemoglobinuria (PNH), a stem cell defect characterized by episodes of complement-induced hemolysis and thromboembolic events. Anticoagulation and antiaggregation were initiated. Subsequently, massive cerebral bleeding developed, to which the patient finally succumbed despite neurosurgical craniectomy. This tragic case illustrates that an antithrombotic treatment is always a balancing act with an unsecure outcome.

Topics: Aged; Anticoagulants; Aspirin; Cerebral Hemorrhage; Clopidogrel; Coronary Thrombosis; Drug Therapy, Combination; Fatal Outcome; Female; Hemoglobinuria, Paroxysmal; Heparin; Heparin, Low-Molecular-Weight; Humans; Phenprocoumon; Platelet Aggregation Inhibitors; Ticlopidine; Tomography, X-Ray Computed