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

Porru, Mariagrazia;Mameli, Antonella;Cianchetti, Maria Elisabetta;MUSU, MARIO;SCHIRRU, PAOLA;RUBERTO, MARIA FILOMENA;BARCELLONA, DORIS;MARONGIU, FRANCESCO

2017-01-01

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Abstract

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