Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918

This article has now been updated. Please use the final version.

Spontaneous Muscle Hematoma in Japanese Patients with Severe COVID-19 Treated with Unfractionated Heparin: Two Case Reports
Yu ItoNobuyasu AwanoFumiya UchiyamaMinoru InomataNaoyuki KuseMari ToneKohei TakadaKazushi FujimotoYutaka MutoShogo SagisakaKenro MakiRyuta YamashitaAkinori HaradaJun-ichi NishimuraMunehiro HayashiTakehiro Izumo
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JOURNAL OPEN ACCESS Advance online publication

Article ID: 7422-21

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Abstract

In hospitalized coronavirus disease 2019 (COVID-19) patients, anticoagulation therapy is administered to prevent thrombosis. However, anticoagulation sometimes causes bleeding complications. We herein report two Japanese cases of severe COVID-19 in which spontaneous muscle hematomas (SMH) developed under therapeutic anticoagulation with unfractionated heparin. Although the activated partial prothrombin time was within the optimal range, contrast-enhanced computed tomography (CECT) revealed SMH in the bilateral iliopsoas muscles in both cases, which required emergent transcatheter embolization. Close monitoring of the coagulation system and the early diagnosis of bleeding complications through CECT are needed in severe COVID-19 patients treated with anticoagulants.

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© 2021 by The Japanese Society of Internal Medicine
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