Extensive catastrophic thromboses from elevation of factor VIII

  • Jacqueline Kropf Department of Internal Medicine, Orlando Regional Healthcare, Orlando, FL, United States.
  • Sarah Cheyney Department of Internal Medicine, Orlando Regional Healthcare, Orlando, FL, United States. https://orcid.org/0000-0003-2055-3422
  • Josselin Vachon Department of Internal Medicine, Orlando Regional Healthcare, Orlando, FL, United States.
  • Philip Flaherty Division of Critical Care Medicine, Orlando Regional Healthcare, Orlando, FL, United States.
  • Mai Vo Division of Critical Care Medicine, Orlando Regional Healthcare, Orlando, FL, United States. https://orcid.org/0000-0002-1187-2707
  • Steve J. Carlan | stevecarlan@gmail.com Division of Academic Affairs and Research, Orlando Regional Healthcare, Orlando, FL, United States. https://orcid.org/0000-0001-9867-8538

Abstract

Catastrophic thrombotic syndrome, otherwise known as thrombotic storm (TS) is an extreme prothrombotic clinical syndrome that presents as rapid onset of multiple thromboembolic events affecting a large variety of vasculature. In recent studies, there has been a correlation of high plasma levels of factor VIII with thrombotic events. We present the case of a young man who exhibited multi-organ failure due to thrombotic storm. A 38-year-old male presented to the emergency department for progressive dyspnea and was diagnosed to have pulmonary embolism. The patient developed respiratory distress requiring intubation and was diagnosed with both an ST-elevation myocardial infarction and right cerebral infarction during the hospital course. The patient expired and autopsy revealed the cause of death to be myocardial, cerebral and renal infarction from widespread vascular thrombosis. Autopsy revealed cause of death to be elevated factor VIII associated thrombotic coagulopathy. Factor VIII level upon autopsy was 375% (55-200%). Although TS is rare, it can be lifethreatening if not recognized early. Survival depends on the prompt initiation and duration of anticoagulation.

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Published
2020-09-04
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Section
Case Reports
Keywords:
Catastrophic thrombosis, factor VIII, arterial thrombosis, venous thrombosis, pulmonary embolus.
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How to Cite
Kropf, J., Cheyney, S., Vachon, J., Flaherty, P., Vo, M., & Carlan, S. J. (2020). Extensive catastrophic thromboses from elevation of factor VIII. Clinics and Practice, 10(3). https://doi.org/10.4081/cp.2020.1265