title: Dabigatran: a cause of hematologic emergency.
abstract: Dabigatran etexilate, a direct thrombin inhibitor, has become an alternative to warfarin for stroke prevention in patients with nonvalvular atrial fibrillation. There remains a concern about its overdose and life-threatening hemorrhage because of unavailability of appropriate coagulation tests to monitor and antidotes to reverse its effects. There are no clinical data about its safety in patients with fluctuating renal function. Multiple bleeding events reported with dabigatran have prompted the U.S. Food and Drug Administration to further investigate these reports. Four clinical cases with life-threatening bleeding, strategies that were used to achieve hemostasis and a brief literature review to demonstrate the hematologic emergency caused by dabigatran are presented in this study.
authors.affiliation: Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD 57105, USA. yasirlal@yahoo.com
authors.forename: Yasir
authors.initials: Y
authors.lastname: Lal
authors.forename: Joel
authors.initials: J
authors.lastname: Van Heukelom
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000991:Antithrombins / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000188:drug therapy; D001562:Benzimidazoles / Q000009:adverse effects*; D000069604:Dabigatran; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011725:Pyridines / Q000009:adverse effects*
chemical_list: D000991:Antithrombins; D001562:Benzimidazoles; D011725:Pyridines; D000069604:Dabigatran