Mima Yohei, Sangatsuda Yuhei, Yasaka Masahiro, Wakugawa Yoshiyuki, Nagata Shinji, Okada Yasushi
Department of Cerebrovascular Medicine, Neurology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Japan.
Intern Med. 2014;53(21):2523-7. doi: 10.2169/internalmedicine.53.2890. Epub 2014 Nov 1.
A 75-year-old man with paroxysmal atrial fibrillation developed a traumatic intracranial hemorrhage during warfarin treatment. The administration of warfarin was stopped and rivaroxaban therapy, a novel oral anticoagulant (NOAC), was started. Immediately, his platelet count decreased to 3.7×10(4) /μL. The platelet count recovered rapidly after cessation of rivaroxaban administration. Development of thrombocytopenia and its rapid recovery was observed again after another administration, and subsequent cessation, of the drug. A diagnosis of rivaroxaban-induced thrombocytopenia was made. The incidence of thrombocytopenia due to NOACs is rare. Careful attention to thrombocytopenia, which is associated with a higher risk for life-threatening bleeding, is therefore necessary during treatment with NOACs.
一名75岁阵发性心房颤动男性在华法林治疗期间发生外伤性颅内出血。停用华法林后开始使用新型口服抗凝药（NOAC）利伐沙班治疗。随即，他的血小板计数降至3.7×10⁴/μL。停用利伐沙班后血小板计数迅速恢复。再次给药及随后停药后，又观察到血小板减少及其快速恢复。诊断为利伐沙班诱导的血小板减少症。NOACs所致血小板减少症的发生率很低。因此，在使用NOACs治疗期间，必须密切关注与危及生命出血风险较高相关的血小板减少症。
