Dabigatran-related leukocytoclastic vasculitis
Josiah An1, Rohan Garje1,2, Karolyn A Wanat3,4
1Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
BMJ Case Reports
|January 6, 2017
Summary
Dabigatran, a novel anticoagulant, may rarely cause leukocytoclastic vasculitis (LCV), a skin condition. This case report details a patient experiencing LCV after starting dabigatran therapy for deep vein thrombosis.
Area of Science:
- Pharmacology
- Dermatology
- Internal Medicine
Background:
- Dabigatran is a widely used direct thrombin inhibitor for anticoagulation.
- Monitoring of serum drug levels is not typically required for dabigatran.
- Limited reports exist regarding significant dermatologic adverse events associated with dabigatran.
Observation:
- A 57-year-old male with chronic deep vein thrombosis was initiated on dabigatran.
- Within three days of starting dabigatran, the patient developed palpable purpura, petechiae, and swelling.
- The skin manifestations were observed on the lower extremities, torso, and distal upper extremities.
Findings:
- The patient's presentation is consistent with leukocytoclastic vasculitis (LCV).
- LCV is an inflammatory small vessel disease.
- This case suggests a potential association between dabigatran and the development of LCV.
Implications:
- This case highlights a rare but serious potential skin side effect of dabigatran.
- Awareness of LCV as a possible adverse reaction to dabigatran is crucial for clinicians.
- Prompt recognition and management are important for patients experiencing these symptoms.
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