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Successful management of unstable angina in a ravulizumab-treated patient with paroxysmal nocturnal hemoglobinuria

Hiroshi Takahashi, Hirotaka Mori, Masahiko Fukatsu, Takahiro Sano, Kayo Harada, Masayoshi Oikawa, Yasuchika Takeishi, Satoshi Kimura, Hiroshi Ohkawara, Tsutomu Shichishima, Takayuki Ikezoe

Author information

  • Hiroshi Takahashi

    Department of Hematology, Fukushima Medical University

  • Hirotaka Mori

    Department of Hematology, Fukushima Medical University

  • Masahiko Fukatsu

    Department of Hematology, Fukushima Medical University

  • Takahiro Sano

    Department of Hematology, Fukushima Medical University

  • Kayo Harada

    Department of Hematology, Fukushima Medical University

  • Masayoshi Oikawa

    Department of Cardiology, Fukushima Medical University

  • Yasuchika Takeishi

    Department of Cardiology, Fukushima Medical University

  • Satoshi Kimura

    Department of Hematology, Fukushima Medical University

  • Hiroshi Ohkawara

    Department of Hematology, Fukushima Medical University

  • Tsutomu Shichishima

    Department of Hematology, Fukushima Medical University

  • Takayuki Ikezoe

    Department of Hematology, Fukushima Medical University

Abstract

Ravulizumab is an anti-C5 antibody approved for treating paroxysmal nocturnal hemoglobinuria (PNH). In August 2019, a 77-year-old Japanese man with PNH, who had been on ravulizumab treatment for 2 years, was hospitalized for chest discomfort and malaise. Electrocardiography identified a right bundle block, and elevated serum troponin I and d-dimer suggested ischemic heart disease. Cardiac catheterization revealed severe stenosis in the left anterior descending coronary artery, and intracoronary stenting relieved his chest discomfort. The final diagnosis was unstable angina unrelated to ravulizumab, and the patient’s ravulizumab treatment was uninterrupted with no significant complications of PNH. This case report highlights the importance of continuing complement inhibition therapy during acute coronary events.

The cintent of reseach paper

References

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