Vujaklija Brajkovic A, Markota A, Bielen L, Vujević A, Rora M, Radonic R. Angiotensin II administration in severe thrombocytopenia and chronic venous thrombosis: A case report. World J Crit Care Med 2024; 13(4): 96755 [DOI: 10.5492/wjccm.v13.i4.96755]
Corresponding Author of This Article
Ana Vujaklija Brajkovic, MD, PhD, Assistant Professor, Department of Internal Medicine, University Hospital Centre Zagreb, Kišpatićeva 12, Zagreb 10000, Croatia. avujaklija@gmail.com
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Crit Care Med. Dec 9, 2024; 13(4): 96755 Published online Dec 9, 2024. doi: 10.5492/wjccm.v13.i4.96755
Angiotensin II administration in severe thrombocytopenia and chronic venous thrombosis: A case report
Ana Vujaklija Brajkovic, Andrej Markota, Luka Bielen, Andro Vujević, Mia Rora, Radovan Radonic
Ana Vujaklija Brajkovic, Luka Bielen, Andro Vujević, Mia Rora, Radovan Radonic, Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb 10000, Croatia
Ana Vujaklija Brajkovic, Luka Bielen, Radovan Radonic, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
Andrej Markota, Department of Intensive Internal Medicine, University Medical Centre Maribor, Maribor 2000, Slovenia
Author contributions: Vujaklija Brajković A and Markota A contributed to conception and design of the study, critically revised the manuscript; Bielen L, Vujević A, and Rora M contributed to acquisition and analysis of data; Vujević A, Rora M and Radonić R jointly drafted the manuscript; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ana Vujaklija Brajkovic, MD, PhD, Assistant Professor, Department of Internal Medicine, University Hospital Centre Zagreb, Kišpatićeva 12, Zagreb 10000, Croatia. avujaklija@gmail.com
Received: May 14, 2024 Revised: August 12, 2024 Accepted: August 19, 2024 Published online: December 9, 2024 Processing time: 169 Days and 21.7 Hours
Abstract
BACKGROUND
The initial trials on angiotensin II (AT II) administration indicated a high incidence of thrombocytopenia and thrombosis, as well as a positive correlation between hyperreninemia and response to the medication.
CASE SUMMARY
We describe a case of a patient presenting with catecholamine resistant septic shock, thrombocytopenia, deep vein thrombosis, and normal renin concentration who responded immediately to AT II treatment. We observed no worsening of thrombocytopenia and no progression of thrombosis or additional thromboses during treatment.
CONCLUSION
Our case underscores the need for individualized assessment of patients for potential therapy with AT II.
Core Tip: Angiotensin II (AT II) is a relatively novel vasopressor used for the treatment of distributive shock in patients who do not respond adequately to treatment with noradrenaline. We describe a young patient with refractory septic shock who promptly responded to AT II despite low renin level. The patient also had severe thrombocytopenia and chronic venous thrombosis that was not aggravated during or after AT II administration. AT II may be a viable option for patients with thrombocytopenia and chronic venous thrombosis, specifically when there is a clear clinical requirement for increased vasopressor support.
