达比加群治疗后出现急性肾损伤和未确诊的免疫球蛋白A肾病。
Acute kidney injury and undiagnosed immunoglobulin A nephropathy after dabigatran therapy.
作者信息
Jansky Laurie, Mukkamala Pallavi, Jebakumar Deborah, Rao Arundhati, Goldson Tove M, Forjuoh Samuel N
机构信息
Department of Family and Community Medicine, Baylor Scott & White Health and College of Medicine, Texas A&M Health Science Center, Temple, Texas.
Department of Pathology, Baylor Scott & White Health and College of Medicine, Texas A&M Health Science Center, Temple, Texas.
出版信息
Proc (Bayl Univ Med Cent). 2018 May 9;31(3):321-323. doi: 10.1080/08998280.2018.1463036. eCollection 2018 Jul.
Dabigatran, a new oral anticoagulant, is a direct thrombin inhibitor used as an alternative to warfarin to reduce the risk of stroke and systemic embolism with nonvalvular atrial fibrillation. We report a case of a man who resumed dabigatran after 6 weeks of prior therapy and began experiencing hematuria with worsening kidney function. Renal biopsy with immunofluorescence and electron microscopy showed mesangial deposits consistent with immunoglobulin A nephropathy. With discontinuation of dabigatran and addition of methylprednisolone, the gross hematuria cleared and urine output improved.
达比加群是一种新型口服抗凝剂，是一种直接凝血酶抑制剂，可作为华法林的替代品，用于降低非瓣膜性心房颤动患者中风和全身性栓塞的风险。我们报告了一例男性患者，在接受了6周的前期治疗后恢复使用达比加群，随后开始出现血尿，肾功能恶化。免疫荧光和电子显微镜检查的肾活检显示系膜沉积物，符合免疫球蛋白A肾病。停用达比加群并加用甲泼尼龙后，肉眼血尿消失，尿量增加。
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