Leech bites: massive bleeding, coagulation profile disorders, and severe anemia
Case report published in Am J Emerg Med (2008)
Resumen
Leeches have been in use for centuries, especially in plastic and reconstructive surgery wound and flap healing, in venous insufficiencies, and in the treatment of many disorders such as hemorrhoids and varicosity. With this study, we aimed to discuss coagulation disorder due to uncontrolled leech bites, consequent excessive skin hemorrhage, and anemia requiring blood transfusion. A 65-year-old male patient was referred to the emergency department because of excessive intractable bleeding that had occurred after leech bites. On physical examination, a total of 130 bites were detected on various regions of the body. In the laboratory findings of the patient, hemoglobin and hematocrit levels were extremely low, and prothrombin time, international normalized ratio, and partial thromboplastin time were markedly increased. The patient received a total of 8 units of fresh frozen plasma and 6 units of erythrocyte suspension. Bleeding stopped by decreasing after the transfusion of fresh frozen plasma. Although the complications due to leech injuries are rare, they may be an important cause of morbidity and mortality when an injury or prolonged bleeding in an internal region occurs. Prolonged skin hemorrhages rarely cause anemia, and deaths are caused by intractable hemorrhages. However, a coagulation disorder and consequent intractable hemorrhage have not been reported previously in the literature. In conclusion, it should be known that uncontrolled, blind, and excessive leech use causes severe hemorrhage and excessive blood loss, causing significant morbidity and mortality. Therefore, the awareness of either physicians or people using or recommending alternative medicine should be raised on this subject.
Resumen tomado de PubMed (NCBI) para el registro citado, en el idioma original. La versión de referencia es la de la publicación original.
El resumen se deja sin traducir para conservar la redacción original de los autores.
Síntesis
Case of 65-year-old male with 130 leech bites causing severe coagulation disorder and anemia requiring 8 units of fresh-frozen plasma and 6 units of erythrocyte suspension.
Por qué esto importa para la hirudoterapia
Este informe de caso documenta a un hombre de 65 años remitido por hemorragia incontrolable después de aproximadamente 130 mordeduras de sanguijuela por todo el cuerpo, que presentaba hemoglobina/hematocrito muy bajo y tiempo de protrombina, INR y tiempo parcial de tromboplastina marcadamente prolongados; la hemorragia se controló solo después de la transfusión de 8 unidades de plasma congelado fresco y 6 unidades de eritrocitos, y los autores señalan que esta combinación de un trastorno de la coagulación con una hemorragia incontrolable consecuente por mordeduras de sanguijuela no se había reportado previamente. Para la hirudoterapia, esta es una referencia de seguridad preventiva: muestra que el uso no controlado, excesivo y no clínico de sanguijuelas puede causar anemia severa y una coagulopatía que requiere transfusión, lo que respalda el posicionamiento de la ASH sobre limitar el número de sanguijuelas, monitorear la hemorragia y evitar la aplicación no supervisada. La advertencia es que este es un caso extremo único impulsado por un número muy grande de mordeduras administradas fuera del control clínico adecuado, por lo que describe un peligro de peor caso en lugar del riesgo esperado de una hirudoterapia medicinal con dosis adecuadas y supervisada.
Citación
Leech bites: massive bleeding, coagulation profile disorders, and severe anemia.
Kose A et al. · The American journal of emergency medicine, 2008
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Añadido a la biblioteca ASH: 27 de mayo de 2026 · Última actualización del sitio: 18 de junio de 2026