Severe hypoprothrombinemia caused by cefmetazole sodium in a patient undergoing hemodialysis: A case report
Abstract
Dear Editor, The patient was a man in his 70s, undergoing hemodialysis for end-stage renal disease due to polycystic kidney. He presented with left lower quadrant abdominal pain, diarrhea, and slight hematochezia. He was hospitalized with a diagnosis of ischemic enteritis and was treated with cefmetazole sodium (2 g/day) (Cefmetazon, Alfresa Pharma Corporation, Osaka, Japan). He exhibited no feeding problems or liver dysfunction before hospitalization. Furthermore, he was not consuming warfarin. The patient was asked to fast for 4 days. His medication with aspirin and lansoprazole for angina pectoris was ceased (Takelda, Takeda Pharmaceutical Co., Ltd, Osaka, Japan). After 1 day, his bloody stools ceased. However, the symptom recurred on the 11th day, and changed to tar-like stool on the 14th day of illness. An upper gastrointestinal tract endoscopy revealed oozing blood in numerous locations in the upper stomach. Therefore, rabeprazole sodium (Pariet, Eizai Co., Ltd, Tokyo, Japan) was administered from the 15th day. During the venipuncture for hemodialysis on the same day, the wall of the vein was punctured with a needle tip, and compression hemostasis was performed. The next day, his upper limb with arteriovenous fistula was swollen by massive internal bleeding, with bleeding originating from the puncture site. On the 17th day, an infusion containing 40 mg of menatetrenone (Kaytwo N, Eisai Co., Ltd., Tokyo, Japan) was immediately administered after drawing blood to test…
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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