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Keimyung Medical Journal 2018;37(2):92-96.
Published online February 11, 2019.
Anesthetic and Perioperative Management of Patient with Paroxysmal Nocturnal Hemoglobinuria.
Eun Kyung Choi, Kwang Beom Kim, Sang Jin Park, Ki Bum Park
1Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine, Daegu, Korea.
2Department of Anesthesiology and Pain Medicine, Keimyung University School of Medicine, Daegu, Korea. Parkkibum@dsmc.or.kr
Abstract
Paroxysmal nocturnal hemoglobinuria (PNH) is a rare clonal hematopoietic stem cell disorder. Surgery, anesthesia, infection, trauma, and pregnancy can exacerbate hemolysis and thrombotic risk by increasing complement activity. However, perioperative treatment of eculizumab can reduce risk of hemolytic event by surgical stress. Here, we present the perioperative clinical course and adequate anesthetic management of PNH complicated by spine surgery under general anesthesia. We also describe a possible role of eculizumab for PNH patients with anticipated high risks.
Key Words: Hemoglobinuria, Hemolysis, Paroxysmal, Thrombosis
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