Case ReportsThe use of recombinant factor VIIa (NovoSeven®) in a patient with a factor XI deficiency and a circulating anticoagulantBillon, S.; Niger, C. Le; Escoffre-Barbe, M.; Vicariot, M.; Abgrall, J. F. Author Information S. Billon, C. Le Niger and M. Vicariot are with the Laboratory of Hematology, and M. Escoffre-Barbe and J. F. Abgrall are with the Department of Hematology, Hôpital Morvan, Brest, France. (Received 10 April 2001; revised 16 June 2001; accepted 19 June 2001) Address correspondence to Sandrine Billon, Laboratory of Hematology, Hôpital Morvan, 29609 Brest Cedex, France. Tel: (+33) 298 223406; e-mail: [email protected] Blood Coagulation & Fibrinolysis: October 2001 - Volume 12 - Issue 7 - p 551-553 Buy Abstract A 75-year-old female known to have a chronic myelomonocytic leukaemia and an acquired FXI deficiency (FXI level, 5%) related to a FXI inhibitor (38 Bethesda units) was admitted to the hospital for acute pneumonia associated with a bulky pleural effusion. A therapeutic puncture was found to be essential for the patient. But, such a procedure is a haemostatic challenge which requires adequate preparation. A first treatment composed of intravenous immunoglobulins and immunosuppressive therapy failed to eradicate the inhibitor and to restore a normal FXI level. In this context, steroids or FXI concentrates were not recommended. Thus, small doses of recombinant activated factor VII were used to achieve haemostasis. The procedure was successful, the tolerance was good and no adverse events occurred. © 2001 Lippincott Williams & Wilkins, Inc.