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Prolonged Hemocoagulase Agkistrodon Halys Pallas Administration Induces Hypofibrinogenemia in Patients with Hematological Disorders: A Clinical Analysis of 11 Patients

Abstract

Hemocoagulase Agkistrodon Halys Pallas, a well-established hemostatic agent used in China, has widespread applications in various conditions of bleeding and hemorrhages. Although it presents a low risk of vascular thrombosis, the agent can be easily tolerated and does not show any harmful effects, except allergy. However, long-term use of hemocoagulase may induce hypofibrinogenemia in some patients. Herein, we report 11 patients of prolonged administration of hemocoagulase Agkistrodon, with particular attention to the dynamic changes in their coagulation functions. A marked decline in the level of fibrinogen was observed in patients suffering from hematological disorders, following an extended exposure to hemocoagulase. Nevertheless, the low fibrinogen levels increased after withdrawal of the agent. Since the D-dimer level did not show any significant increase, hemocoagulase inducing lower fibrinogen may be considered to be a process of primary fibrinolysis. In conclusion, we suggested that hemocoagulase must be cautiously used in patients with hematological disorders, because of the potential risk of fibrinolysis; and the coagulation functions should be carefully evaluated during the administration of hemocoagulase.

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References

  1. Liu Y (2016) Clinical effect observation on mangabeys hemocoagulase injection treatment of premature infants with gastrointestinal bleeding. J Pediatric Pharm 22(1):25–27. doi:10.13407/j.cnki.jpp.1672-108X.2016.01.010

    Google Scholar 

  2. Sachin A, Pg F, Bhs R, Ummar M, Jk I, Rb N (2013) A double blind study on the efficacy of local application of hemocoagulase solution in wound healing. J Contemp Dental Pract 14(3):394–400. doi:10.5005/jp-journals-10024-1334

    Google Scholar 

  3. Li Y (2011) Hemocoagulase injection blood anesthesia in joint operation. J Med Coll PLA 26(3):152–157

    CAS  Article  Google Scholar 

  4. Yuan S, Shifang T, Huangqiang L, Jinning Z, Feng P (2005) New treatment of neonatal pulmonary hemorrhage with hemocoagulase in addition to mechanical ventilation. Biol Neonate 88(2):118–121

    Article  Google Scholar 

  5. Wei JM, Zhu MW, Zhang ZT, Jia ZG, He XD, Wan YL et al (2010) A multicenter, phase III trial of hemocoagulase Agkistrodon: hemostasis, coagulation, and safety in patients undergoing abdominal surgery. Chin Med J 123(5):589–593

    CAS  PubMed  Google Scholar 

  6. Hui-Min L, Chang-Ling LI, Dong JC, Zhang CL (2008) Hemostatic effect of hemocoagulase agkistrodon and its mechanism. J Exp Hematol 16(4):883–885

    Google Scholar 

  7. Wei JM, Zhu MW, Zhang ZT, Jia ZG, Xiao-Dong HE, Wan YL et al (2007) The effects of hemocoagulase agkistrodon on its hemostatic and hemoagglutinant function, on abdominal incision and safety in surgical patients, a multicenter clinical study. Chin J New Drugs 16(14):1126–1129

    Google Scholar 

  8. World Medical Association (2000) Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 284(23):3043–3045

    Article  Google Scholar 

  9. Jr TF, Toh CH, Hoots WK et al (2001) Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation. Thromb Haemost 86(5):1327

    Google Scholar 

  10. Bruck H, Salem G (1954) Reptilase, a hemostatic for prophylaxis and therapy in surgical operations. Wien Klin Wochenschr 66(22):395–397

    CAS  PubMed  Google Scholar 

  11. Castro HC, Zingali RB, Albuquerque MG, Pujol-Luz M, Rodrigues CR (2004) Snake venom thrombin-like enzymes: from reptilase to now. Cell Mol Life Sci 61(7–8):843–856. doi:10.1007/s00018-003-3325-z

    CAS  Article  PubMed  Google Scholar 

  12. Lu HM, Li CL, Dong JC, Zhang CL, Zhou XY (2008) Hemostatic effect of hemocoagulase agkistrodon and its mechanism. Zhongguo Shi Yan Xue Ye Xue Za Zhi 16(4):883–885

    CAS  PubMed  Google Scholar 

  13. Zeng Z, Xiao P, Chen J, Wei Y (2009) Are batroxobin agents effective for perioperative hemorrhage in thoracic surgery? A systematic review of randomized controlled trials. Blood Coagul Fibrinolysis Int J Haemost Thrombosis 20(2):101–107. doi:10.1097/MBC.0b013e3283254532

    CAS  Article  Google Scholar 

  14. Xu YY, Li BL, Jin YL, Wang ZX, Song XR, Ni J (2014) Serious anaphylactic shock induced by hemocoagulase agkistrodon during anesthesia in a 5-year-old child. Int J Clin Exp Med 8(3):4727–4730

    Google Scholar 

  15. Wang Z, Li J, Cao L, Yu Z, Bai X, Ruan C (2014) Hypofibrinogenemia caused by long-term administration of hemocoagulase: three cases report and literature review. Zhong Hua Xue Ye Xue Za Zhi. 35(1):50–52. doi:10.3760/cma.j.issn.0253-2727.2014.01.013

    Google Scholar 

  16. Xu YY, Ma XH, Zhang SJ (2016) Hemocoagulase agkistrodon-induced anaphylactic shock: a case report and literature review. Int J Clin Pharmacol Ther 54(2):129–134. doi:10.5414/cp202296

    CAS  Article  PubMed  Google Scholar 

  17. Xu G, Liu X, Zhu W, Yin Q, Zhang R, Fan X (2007) Feasibility of treating hyperfibrinogenemia with intermittently administered batroxobin in patients with ischemic stroke/transient ischemic attack for secondary prevention. Blood Coagul Fibrinolysis Int J Haemost Thrombosis 18(2):193–197. doi:10.1097/MBC.0b013e328040c0f2

    CAS  Article  Google Scholar 

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Wu Dijiong contributed to the conception of the study. Xu Linglong contributed to data collection, performed the data analyses and wrote the manuscript.

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Correspondence to Wu Dijiong.

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Linglong, X., Dijiong, W. Prolonged Hemocoagulase Agkistrodon Halys Pallas Administration Induces Hypofibrinogenemia in Patients with Hematological Disorders: A Clinical Analysis of 11 Patients. Indian J Hematol Blood Transfus 34, 322–327 (2018). https://doi.org/10.1007/s12288-017-0859-z

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  • DOI: https://doi.org/10.1007/s12288-017-0859-z

Keywords

  • Batroxobin
  • Anemia
  • Aplastic
  • Fibrinolysis
  • Afibrinogenemia
  • Myelodysplastic syndromes