Department of Medicine, Hamad General Hospital, Doha, Qatar.
Pan Afr Med J. 2021 Apr 6;38:333. doi: 10.11604/pamj.2021.38.333.28401. eCollection 2021.
We reported an anaphylactic reaction following ingestion of rivaroxaban in a 48-years-old male, who was recently discharged from the hospital as a case of deep vein thrombosis. At home, the patient developed a diffuse itchy skin rash, shortness of breath, and vomiting 30 minutes after rivaroxaban ingestion. Emergency Medical Service found that the patient had severe dyspnea, low blood pressure, and decreased blood oxygen saturation. The patient was given oxygen, intramuscular epinephrine, intravenous hydrocortisone, diphenhydramine, salbutamol nebulizer, and was immediately transferred to the emergency department of Hamad General Hospital. Subcutaneous enoxaparin was initiated, while hydrocortisone and salbutamol nebulizer continued. On the next day, his vital signs had stabilized, and intravenous hydrocortisone was switched to prednisolone tablets, and salbutamol nebulizer was switched to budesonide/salmeterol inhaler, whereas enoxaparin was overlapped with warfarin. After achieving the target international normalized ratio (INR), enoxaparin was discontinued and the patient was discharged with significant clinical and laboratory improvement.
我们报告了一例 48 岁男性在服用利伐沙班后出现过敏反应的病例，该患者最近因深静脉血栓形成出院。在家中，患者在服用利伐沙班 30 分钟后出现全身弥漫性瘙痒性皮疹、呼吸急促和呕吐。急救医疗服务中心发现患者有严重的呼吸困难、低血压和血氧饱和度降低。给予患者吸氧、肌肉内肾上腺素、静脉内氢化可的松、苯海拉明、沙丁胺醇雾化吸入，并立即转往哈马德综合医院急诊科。皮下给予依诺肝素，同时继续给予氢化可的松和沙丁胺醇雾化吸入。第二天，患者生命体征稳定，静脉内氢化可的松改为泼尼松片，沙丁胺醇雾化吸入改为布地奈德/福莫特罗吸入剂，依诺肝素与华法林重叠使用。达到目标国际标准化比值（INR）后，停止使用依诺肝素，患者出院时临床和实验室指标显著改善。
