University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey.
University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey.
Transfus Apher Sci. 2020 Dec;59(6):102883. doi: 10.1016/j.transci.2020.102883. Epub 2020 Jul 22.
Rivaroxaban is a novel, oral direct acting anticoagulant (DOAC) that is used for both treatment and prevention of thromboembolic diseases. Due to mechanism of action; most common side effect may be seen with hemorrhage. Here in we reported that a patient with chronic atrial fibrillation presented with thrombocytopenia while taking rivaroxaban.
A 76-year-old female patient with atrial fibrillation was given rivaroxaban, after lack of dose administration of warfarin and gastrointestinal bleeding. In 12th dayweek of treatment, the patient was admitted to emergency department (ED) with oral mucosal bleeding and petechial spots.The patient diagnosed as Drug-induced Thrombocytopenia (DITP)due to rivaroxaban use, after ruled out most possibilities ofITP (immune thrombocytopenic purpura). After rivaroxaban is discontinued, the patient's bleeding complaints regressed,symptoms were completely resolved, and platelet count rapidly increased towards physiological level in days. The patient is currently in the 6th month of follow-up and is has no bleeding.
To the best of our knowledge there are only two cases about rivaroxaban induced thrombocytopenia (RIT). In addition to the well-known side effects ofrivaroxaban treatment, it should be kept in mind that thrombocytopenia may also develop.Naranjo adverse drug reaction probability scale calculated as 7 points.(probable cause for the patient's thrombocytopenia).
利伐沙班是一种新型的、口服的直接作用抗凝剂（DOAC），用于治疗和预防血栓栓塞性疾病。由于其作用机制，最常见的副作用可能是出血。在这里，我们报告了一例慢性心房颤动患者在服用利伐沙班时出现血小板减少症。
一名 76 岁的女性心房颤动患者在停止使用华法林和出现胃肠道出血后开始服用利伐沙班。在治疗的第 12 天，患者因口腔黏膜出血和瘀点而被紧急送往急诊部（ED）。由于使用利伐沙班，患者被诊断为药物诱导的血小板减少症（DITP），排除了 ITP（免疫性血小板减少性紫癜）的大多数可能性。停止使用利伐沙班后，患者的出血症状消退，症状完全缓解，血小板计数在数天内迅速升高至生理水平。目前患者正在接受 6 个月的随访，无出血症状。
据我们所知，仅有两例关于利伐沙班引起的血小板减少症（RIT）的报道。除了利伐沙班治疗的已知副作用外，还应注意到血小板减少症也可能发生。纳拉吉不良反应概率量表评分为 7 分（可能是导致患者血小板减少的原因）。
