Idarucizumab reverses dabigatran-induced anticoagulation in treatment of gastric bleeding:A case report  

作　　者：Yu Jia Shao-Hua Wang Na-Juan Cui Quan-Xi Liu Wei Wang Xue Li Ya-Mei Gu Yan Zhu 

机构地区：[1]Department of Gastroenterology,Hospital of Integrated Traditional Chinese and Western Medicine,Beijing 100039,China [2]Department of General Practice,Tiancun Community Health Service Centre,Beijing 100049,China

出　　处：《World Journal of Clinical Cases》2022年第8期2537-2542,共6页世界临床病例杂志

摘　　要：BACKGROUND The drug instructions for dabigatran recommend adjusting the dosage to 110 mg twice daily for patients with bleeding risk,and performing at least one renal function test per year for patients with moderate renal impairment.However,owing to chronic insidiously worsening renal insufficiency,dabigatran can still accumulate abnormally,necessitating therapy with idarucizumab to reverse the anticoagulation due to severe erosive gastritis with widespread stomach mucosal bleeding.CASE SUMMARY A 76-year-old woman with a history of atrial fibrillation who took dabigatran 110 mg twice daily as directed to lessen the chance of stroke,was transported to the hospital with hematemesis and melena.Laboratory findings revealed severe lifethreatening,blood-loss-induced anemia with a hemoglobin(Hb)level of 41.0 g/L and marked coagulation abnormalities with thrombin time(TT)>180 s,most likely caused by dabigatran-induced metabolic disorder.Aggressive acid suppressive,hemostatic,and blood transfusion therapy resulted in the misconception that the bleeding was controlled,with subsequent rebleeding.Idarucizumab was administered in a timely manner to counteract dabigatran’s anticoagulant impact,and 12 h later,TT was determined to be 17.4 s,which was within the normal range.Finally,the patient had no active bleeding signs and laboratory findings showed an Hb level of 104 g/L and TT of 17.7 s.CONCLUSION Renal function,coagulation function,and dabigatran concentration should be regularly monitored in older patients.Proton pump inhibitor and dabigatran coadministration is still controversial in preventing upper gastrointestinal tract bleeding.

关 键 词：Idarucizumab DABIGATRAN Gastric bleeding Atrial fibrillation Case report 

分 类 号：R573[医药卫生—消化系统]