Affiliation:
1. Department of Clinical Pharmacy, School of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah, Iran.
2. Department of Internal Medicine, School of Medicine Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Abstract
Abstract:
Drug-induced thrombocytopenia can occur in hospitalized patients and complicate their antithrombotic treatment. Several medications can associate thrombocytopenia with immune and non-immune mechanisms. Thrombocytopenia can occur at any time from a few hours to months after a new medication initiation. In this study, we have described the case of a female patient with acute-on-chronic kidney injury following a non-steroidal anti-inflammatory agent use, who developed catheter-related thrombosis and was treated with heparin without any complication for 5 days. She was discharged after 5 days and prescribed to use apixaban 2.5 mg twice daily. However, she was readmitted after 24 hours with fatigue, petechiae, and severe thrombocytopenia (7000/mm3). The workup was negative for other reasons of thrombocytopenia. With a possible diagnosis of drug-related thrombocytopenia, apixaban was discontinued. Following the treatment with the intravenous immunoglobulin, her platelet counts increased and stabilized around 40-50,000/mm3. Anticoagulation was thus continued with adjusted doses of rivaroxaban (10-15 mg/day). 17 days after apixaban discontinuation and treatment with prednisolone, her platelet count increased to 108,000/mm3. With reference to this case, a brief review on refractory heparin-induced thrombocytopenia and the association of direct oral anticoagulants with thrombocytopenia is presented.
Publisher
Bentham Science Publishers Ltd.
Subject
Pharmacology (medical),General Pharmacology, Toxicology and Pharmaceutics
Cited by
1 articles.
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1. Apixaban/Heparin;Reactions Weekly;2024-07-27