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Dabigatran overdose: a case report of acute hepatitis. Extracorporeal treatment

Mariagrazia Porru1, Antonella Mameli2, Maria E Cianchetti1

  • 1Internal Medicine and Haemocoagulopathies Unit, Azienda Ospedaliero Universitaria (A.O.U.), Presidio "Duilio Casula", University of Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy.

International Journal of Hematology
|December 3, 2016
PubMed

Dabigatran is an oral, direct thrombin inhibitor approved by international regulatory agencies for stroke prevention in patients with paroxysmal or persistent non-rheumatic atrial fibrillation (AF). The benefits of dabigatran are widely described, but its use in the geriatric population is not without risk. Chronic kidney disease is a common comorbidity with AF, and thus frequent checks of renal function in elderly patients are recommended. We report a case of dabigatran intoxication in an elderly man affected by heart failure and worsening renal function, who developed acute hepatitis and coma, which was successfully treated with continuous veno-venous hemodiafiltration. Although extracorporeal therapy has been suggested as a strategy for clearing dabigatran during acute bleeding, this approach may be useful in other dabigatran-related, life-threatening conditions, such as that described in this report.

Keywords:
Acute hepatitisContinuous veno-venous hemodiafiltrationDabigatran etexilateOverdose

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