Successful treatment with dabigatran for consumptive coagulopathy associated with extensive vascular malformations

Area of Science:

• Hematology
• Vascular Medicine

Background:

• Localized intravascular coagulopathy (LIC) is a consumptive coagulopathy complicating vascular malformations, presenting with low fibrinogen and high D-dimer.
• Disseminated intravascular coagulation (DIC) is a severe complication of LIC, leading to significant morbidity.

Purpose of the Study:

• To report a case of DIC secondary to extensive vascular malformations in a young patient.
• To evaluate the efficacy and safety of dabigatran in managing DIC associated with vascular malformations.

Main Methods:

• A 17-year-old female with extensive vascular malformations and DIC, requiring frequent red blood cell transfusions, was treated with dabigatran.
• Coagulation parameters and transfusion requirements were monitored before and after dabigatran administration.

Main Results:

• Dabigatran administration led to rapid improvement in coagulation test results.
• The patient experienced a significant reduction in red blood cell transfusion needs and tolerated dabigatran well over a seven-month follow-up period.

Conclusions:

• Dabigatran may represent a novel and effective therapeutic option for managing DIC in patients with underlying vascular malformations.
• This case highlights a potential treatment strategy for a rare but serious complication of vascular anomalies.