Systemic Inflammatory Response and Severe Thrombocytopenia after Endovascular Thoracic Aortic Aneurysm Repair
After Endovascular repair of thoracic aortic aneurysm, a systemic inflammatory response, named postimplantation syndrome, can develop. This syndrome is characterized by fever, leukocytosis, and elevated CRP plasma levels and its pathogenetic mechanisms are still unknown. Although this syndrome gener...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2017/3018919 |
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| author | Valentina Silvestrin Stefano Bonvini Michele Antonello Franco Grego Roberto Vettor Marco Rossato |
| author_facet | Valentina Silvestrin Stefano Bonvini Michele Antonello Franco Grego Roberto Vettor Marco Rossato |
| author_sort | Valentina Silvestrin |
| collection | DOAJ |
| description | After Endovascular repair of thoracic aortic aneurysm, a systemic inflammatory response, named postimplantation syndrome, can develop. This syndrome is characterized by fever, leukocytosis, and elevated CRP plasma levels and its pathogenetic mechanisms are still unknown. Although this syndrome generally resolves within few days, some patients develop a persisting severe inflammatory reaction leading to mild or severe complications. Here we describe the case of a male patient who developed postimplantation inflammatory syndrome and severe thrombocytopenia after endovascular repair of thoracic aortic aneurysm. Treatment with prednisone (50 mg/bid) for two weeks did not improve the clinical and laboratory findings. We utilized danazol, a weak androgen that has been shown to be effective in the treatment of immune and idiopathic thrombocytopenic purpura, and after 12 days of treatment with danazol (200 mg/bid), the patient improved progressively and platelet number increased up to 53,000/μL. Patients undergoing endovascular repair of thoracic aortic aneurysm should be carefully monitored for the development of postimplantation syndrome. This clinical condition is relatively common after the endovascular repair of aortic aneurysm but is rarely observed after endovascular repair of thoracic aortic aneurysms. The different known therapeutical approaches are still empiric, with reported beneficial effects with the use of NSAID, corticosteroids, and danazol. |
| format | Article |
| id | doaj-art-513f9baa13d749ac938c470e7aa268ff |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-513f9baa13d749ac938c470e7aa268ff2025-02-03T01:23:17ZengWileyCase Reports in Medicine1687-96271687-96352017-01-01201710.1155/2017/30189193018919Systemic Inflammatory Response and Severe Thrombocytopenia after Endovascular Thoracic Aortic Aneurysm RepairValentina Silvestrin0Stefano Bonvini1Michele Antonello2Franco Grego3Roberto Vettor4Marco Rossato5Department of Medicine-DIMED, Clinica Medica 3, University Hospital of Padova, Padova, ItalyDepartment of Cardiac, Thoracic and Vascular Sciences, Division of Vascular and Endovascular Surgery, University of Padova, Padova, ItalyDepartment of Cardiac, Thoracic and Vascular Sciences, Division of Vascular and Endovascular Surgery, University of Padova, Padova, ItalyDepartment of Cardiac, Thoracic and Vascular Sciences, Division of Vascular and Endovascular Surgery, University of Padova, Padova, ItalyDepartment of Medicine-DIMED, Clinica Medica 3, University Hospital of Padova, Padova, ItalyDepartment of Medicine-DIMED, Clinica Medica 3, University Hospital of Padova, Padova, ItalyAfter Endovascular repair of thoracic aortic aneurysm, a systemic inflammatory response, named postimplantation syndrome, can develop. This syndrome is characterized by fever, leukocytosis, and elevated CRP plasma levels and its pathogenetic mechanisms are still unknown. Although this syndrome generally resolves within few days, some patients develop a persisting severe inflammatory reaction leading to mild or severe complications. Here we describe the case of a male patient who developed postimplantation inflammatory syndrome and severe thrombocytopenia after endovascular repair of thoracic aortic aneurysm. Treatment with prednisone (50 mg/bid) for two weeks did not improve the clinical and laboratory findings. We utilized danazol, a weak androgen that has been shown to be effective in the treatment of immune and idiopathic thrombocytopenic purpura, and after 12 days of treatment with danazol (200 mg/bid), the patient improved progressively and platelet number increased up to 53,000/μL. Patients undergoing endovascular repair of thoracic aortic aneurysm should be carefully monitored for the development of postimplantation syndrome. This clinical condition is relatively common after the endovascular repair of aortic aneurysm but is rarely observed after endovascular repair of thoracic aortic aneurysms. The different known therapeutical approaches are still empiric, with reported beneficial effects with the use of NSAID, corticosteroids, and danazol.http://dx.doi.org/10.1155/2017/3018919 |
| spellingShingle | Valentina Silvestrin Stefano Bonvini Michele Antonello Franco Grego Roberto Vettor Marco Rossato Systemic Inflammatory Response and Severe Thrombocytopenia after Endovascular Thoracic Aortic Aneurysm Repair Case Reports in Medicine |
| title | Systemic Inflammatory Response and Severe Thrombocytopenia after Endovascular Thoracic Aortic Aneurysm Repair |
| title_full | Systemic Inflammatory Response and Severe Thrombocytopenia after Endovascular Thoracic Aortic Aneurysm Repair |
| title_fullStr | Systemic Inflammatory Response and Severe Thrombocytopenia after Endovascular Thoracic Aortic Aneurysm Repair |
| title_full_unstemmed | Systemic Inflammatory Response and Severe Thrombocytopenia after Endovascular Thoracic Aortic Aneurysm Repair |
| title_short | Systemic Inflammatory Response and Severe Thrombocytopenia after Endovascular Thoracic Aortic Aneurysm Repair |
| title_sort | systemic inflammatory response and severe thrombocytopenia after endovascular thoracic aortic aneurysm repair |
| url | http://dx.doi.org/10.1155/2017/3018919 |
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