Diffuse Alveolar Hemorrhage Secondary to Apixaban Administration

Gabrilovich, Michael; Buxton, Daniel E.; Lykins, Danielle M.; McMillen, Susan M.; Onadeko, Oluwole

doi:10.1378/chest.14-0651

Cited by 13 publications

(7 citation statements)

References 4 publications

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“…8 DAH because of oral anticoagulant overdose has been described with warfarin, a vitamin K antagonist, which is the most common and widest used oral anticoagulant, 9 dabigatran, a novel direct thrombin inhibitor agent which is sometimes preferred to warfarin as it does not require frequent blood tests for INR monitoring, 10 and apixaban, a novel direct inhibitor of factor Xa. 11 In a retrospective 25-year follow-up study recently published, Levine et al 9 described 23 patients with warfarin overdose and only a minority of them (3 out of 23) had bleeding events, 1 classified as major and 2 as minor; all patients fully recovered with appropriate treatment.…”

Section: Discussionmentioning

confidence: 99%

A Bloody Mess: An Unusual Case of Diffuse Alveolar Hemorrhage Because of Warfarin Overdose

Heffler

Campisi²,

Ferri³

et al. 2016

American Journal of Therapeutics

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We herein present the case of a patient with frank hemoptysis and hematuria, dyspnea, and cough. The patient was known to be affected by Chronic Obstructive Pulmonary Disease (COPD) and dilated cardiomyopathy with atrial fibrillation. For this latter condition, he was supposed to take 1.25 mg warfarin daily. Laboratory findings revealed very high levels of International Normalized Ratio (INR) (16), and the patient referred that he self-increased warfarin dose to 5 mg daily since 8 days before the onset of symptoms. Computed tomography scan revealed diffuse bilateral signs of alveolar hemorrhage with hydroaerial levels within emphysematous cysts. Wafarin was immediately stopped and changed with 220 mg dabigatran daily, and he was properly treated to restore a normal coagulation status. We concluded for a case of diffuse alveolar hemorrhage because of warfarin overdose.A 64-year-old heavy male smoker (69 pack-years: about 30 cigarettes per day in the last 46 years) with a known diagnosis of COPD characterized by diffuse emphysema and bronchiectasis chronically treated with inhaled 50/500 salmeterol/fluticasone b.i.d. and inhaled 18 mg tiotrope bromure o.d. was admitted in Emergency Department (ED) for blood-streaked sputum coughed up from lower airways.Dilated cardiomyopathy with atrial fibrillation was the only relevant known comorbidity; 3 years ago, he underwent pharmacological cardioversion with intravenous (i.v.) amiodarone, after which he was advised to chronically take an oral anticoagulant, warfarin,

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Section: Discussionmentioning

confidence: 99%

A Bloody Mess: An Unusual Case of Diffuse Alveolar Hemorrhage Because of Warfarin Overdose

Heffler

Campisi²,

Ferri³

et al. 2016

American Journal of Therapeutics

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“…We believe that this may be an under-recognized condition as multiple cases were identified in our institution, yet literature reports are rare. There are case reports of alveolar hemorrhage associated with nearly all anticoagulants, including warfarin [12], low molecular weight heparin [13], and apixaban [14]. The patients highlighted in this case series all had underlying conditions that may have predisposed them to the complication of alveolar hemorrhage.…”

Section: Resultsmentioning

confidence: 97%

Alveolar Hemorrhage Associated with Rivaroxaban: A Case Series

Laird-Fick¹,

Grondahl²,

Benedict³

et al. 2017

J Pulm Respir Med

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“…Although the mortality rate varies according to the etiology, it has been reported to range between 25% and 50% (4,5) . DAH develops as a rare complication of anticoagulants as warfarin, dabigatran, apixaban and edoxaban (6)(7)(8)(9) .…”

Section: Discussionmentioning

confidence: 99%

Diffusie Alveolar Hemorrhage-Complication of Warfarin Treatment

Aliyev¹,

Özer²,

Şahi̇n³

et al. 2019

IKSST

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Diffuse alveolar hemorrhage (DAH) is a medical emergency which can cause acute respiratory failure. The diagnosis and treatment of DAH should be carried out as soon as possible. DAH has various causes such as vasculitis, infections, pesticides intoxication, barotrauma, diffuse alveolar damage, pulmonary embolism and may be associated with the use of anticoagulants (1). Warfarin therapy is a rare cause of DAH (1). We aimed to present a 69 year-old male patient who developed diffuse alveolar hemorrhage as a complication of warfarin therapy used for valve replacement. After diagnosis of DAH, warfarin treatment was discontinued and fresh frozen plasma, metilprednisolone, vitamin K were administered during mechanical ventilation therapy. The patient was responded well and INR decreased to therapeutic value. DAH should be remembered during warfarine therapy to avoid challenging situations.

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Diffuse Alveolar Hemorrhage Secondary to Apixaban Administration

Cited by 13 publications

References 4 publications

A Bloody Mess: An Unusual Case of Diffuse Alveolar Hemorrhage Because of Warfarin Overdose

A Bloody Mess: An Unusual Case of Diffuse Alveolar Hemorrhage Because of Warfarin Overdose

Alveolar Hemorrhage Associated with Rivaroxaban: A Case Series

Diffusie Alveolar Hemorrhage-Complication of Warfarin Treatment

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