Dabigatran Kullanımına Sekonder Nadir Görülen Ciddi Koagülopati

Abstract

Dabigatran atriyal fibrilasyon (AF) varlığında oluşabilecek inmelerin önlenmesinde kullanılan oral direkt trombin inhibitörüdür. Vitamin K antagonistleri ve varfarin kullanımına kıyasla kanama yan etkilerinin daha az görülmesi ve laboratuar takibi gerektirmemesi açısından güvenle tercih edilebileceği savunulmaktadır. Bu yazıda dabigatran kullanımına bağlı ciddi kanama bozukluğu gelişen 83 yaşındaki bilinen kronik renal hasar, epilepsi, AF tanıları olan bayan hasta sunuldu. Oral antikoagülan ilaçlar atriyal fibrilasyon olgularında sistemik tromboemboliler ve iskemik inmelerin önlenmesinde önem arz etmektedir fakat vakamızda olduğu gibi ciddi kanamalara yol açabilmektedir. Renal yetmezlik gibi hastalığı olan yaşlı hastalarda antikoagulan ilaçların doz ayarlanması dikkatlice yapılması gerekmektedir. Vakamız dabigatran kullanımına bağlı kanama ile PT, aPTT ve INR değerlerinde belirgin uzamanın görüldüğü nadir vakalar arasında yer alması nedeniyle ilginçtir.

Keywords

• Antikoagülanlar
• Atriyal Fibrilasyon
• Böbrek Yetmezliği
• Dabigatran
• Kanama

Rare Severe Coagulopathy Secondary Due to Dabigatran Use

Abstract

Dabigatran is an oral direct thrombin inhibitor used to prevent strokes that may occur in the presence of atrial fibrillation (AF). Compared to the use of vitamin K antagonists and warfarin, it is argued that it can be safely preferred in terms of less bleeding side effects and not requiring laboratory follow-up. In this case-report, an 83-year-old female patient with known chronic renal damage, epilepsy and AF who developed severe bleeding disorder due to dabigatran use is presented. Oral anticoagulant drugs are important in the prevention of thromboembolism, but they can cause serious bleeding as in our case. In cases such as renal insufficiency, the dose of anticoagulant drugs should be carefully adjusted. Our case is interesting because it is among the rare cases in which a significant prolongation of PT, aPTT and INR values are observed due to bleeding due to dabigatran use.

Keywords

• Anticoagulants
• Atrial Fibrillation
• Dabigatran
• Hemorrhage
• Renal Insufficiency

References

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