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Bilateral Femoral Neuropathy Following Psoas Muscle Hematomas Caused by Enoxaparin Therapy

Patient: Female, 64 Final Diagnosis: Bilateral femoral neuropathy Symptoms: Inability to walk Medication: — Clinical Procedure: None Specialty: Critical Care Medicine OBJECTIVE: Adverse events of drug therapy BACKGROUND: Femoral neuropathy as a result of retroperitoneal hemorrhage most commonly occu...

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Autores principales: Macauley, Precious, Soni, Parita, Akkad, Isaac, Demir, Selma, Shankar, Shyam, Kakar, Parul, Bhardwaj, Sharonlin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590513/
https://www.ncbi.nlm.nih.gov/pubmed/28848224
http://dx.doi.org/10.12659/AJCR.904975
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author Macauley, Precious
Soni, Parita
Akkad, Isaac
Demir, Selma
Shankar, Shyam
Kakar, Parul
Bhardwaj, Sharonlin
author_facet Macauley, Precious
Soni, Parita
Akkad, Isaac
Demir, Selma
Shankar, Shyam
Kakar, Parul
Bhardwaj, Sharonlin
author_sort Macauley, Precious
collection PubMed
description Patient: Female, 64 Final Diagnosis: Bilateral femoral neuropathy Symptoms: Inability to walk Medication: — Clinical Procedure: None Specialty: Critical Care Medicine OBJECTIVE: Adverse events of drug therapy BACKGROUND: Femoral neuropathy as a result of retroperitoneal hemorrhage most commonly occurs following pelvic and lower extremity trauma, but has been described to develop as a less frequent complication of anticoagulation. CASE REPORT: We present the case of a 64-year-old white woman who was being treated for pulmonary embolism and deep venous thrombosis with enoxaparin. In the course of her treatment, she was noted to be hypotensive, with a sudden drop in hematocrit. She had been previously ambulatory, but noted an inability to move her bilateral lower extremities. A diagnosis of bilateral femoral neuropathy as a result of psoas hematomas caused by enoxaparin was made. Anticoagulation was discontinued and she was treated conservatively, with an excellent outcome. At the time of discharge to a rehabilitation center, she had regained most of the motor strength in her lower extremities. CONCLUSIONS: We believe this is the first reported case of bilateral femoral nerve neuropathy following use of enoxaparin. A full neurological examination should always be performed when there is sudden loss of function. The constellation of bilateral groin pain, loss of lower extremity mobility, and decreased hematocrit raised the suspicion of massive blood loss into the cavity/compartment. Thus, a high index of suspicion should be maintained by clinicians when presented with such symptoms and signs, as there can be significant morbidity and mortality when prompt diagnosis is not made.
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spelling pubmed-55905132017-09-14 Bilateral Femoral Neuropathy Following Psoas Muscle Hematomas Caused by Enoxaparin Therapy Macauley, Precious Soni, Parita Akkad, Isaac Demir, Selma Shankar, Shyam Kakar, Parul Bhardwaj, Sharonlin Am J Case Rep Articles Patient: Female, 64 Final Diagnosis: Bilateral femoral neuropathy Symptoms: Inability to walk Medication: — Clinical Procedure: None Specialty: Critical Care Medicine OBJECTIVE: Adverse events of drug therapy BACKGROUND: Femoral neuropathy as a result of retroperitoneal hemorrhage most commonly occurs following pelvic and lower extremity trauma, but has been described to develop as a less frequent complication of anticoagulation. CASE REPORT: We present the case of a 64-year-old white woman who was being treated for pulmonary embolism and deep venous thrombosis with enoxaparin. In the course of her treatment, she was noted to be hypotensive, with a sudden drop in hematocrit. She had been previously ambulatory, but noted an inability to move her bilateral lower extremities. A diagnosis of bilateral femoral neuropathy as a result of psoas hematomas caused by enoxaparin was made. Anticoagulation was discontinued and she was treated conservatively, with an excellent outcome. At the time of discharge to a rehabilitation center, she had regained most of the motor strength in her lower extremities. CONCLUSIONS: We believe this is the first reported case of bilateral femoral nerve neuropathy following use of enoxaparin. A full neurological examination should always be performed when there is sudden loss of function. The constellation of bilateral groin pain, loss of lower extremity mobility, and decreased hematocrit raised the suspicion of massive blood loss into the cavity/compartment. Thus, a high index of suspicion should be maintained by clinicians when presented with such symptoms and signs, as there can be significant morbidity and mortality when prompt diagnosis is not made. International Scientific Literature, Inc. 2017-08-29 /pmc/articles/PMC5590513/ /pubmed/28848224 http://dx.doi.org/10.12659/AJCR.904975 Text en © Am J Case Rep, 2017 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Macauley, Precious
Soni, Parita
Akkad, Isaac
Demir, Selma
Shankar, Shyam
Kakar, Parul
Bhardwaj, Sharonlin
Bilateral Femoral Neuropathy Following Psoas Muscle Hematomas Caused by Enoxaparin Therapy
title Bilateral Femoral Neuropathy Following Psoas Muscle Hematomas Caused by Enoxaparin Therapy
title_full Bilateral Femoral Neuropathy Following Psoas Muscle Hematomas Caused by Enoxaparin Therapy
title_fullStr Bilateral Femoral Neuropathy Following Psoas Muscle Hematomas Caused by Enoxaparin Therapy
title_full_unstemmed Bilateral Femoral Neuropathy Following Psoas Muscle Hematomas Caused by Enoxaparin Therapy
title_short Bilateral Femoral Neuropathy Following Psoas Muscle Hematomas Caused by Enoxaparin Therapy
title_sort bilateral femoral neuropathy following psoas muscle hematomas caused by enoxaparin therapy
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590513/
https://www.ncbi.nlm.nih.gov/pubmed/28848224
http://dx.doi.org/10.12659/AJCR.904975
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