title: [Dabigatran as cause of severe gastrointestinal bleeding in a Jehovah's Witness patient].
abstract: We report a case of severe gastrointestinal bleeding in a Jehovah's Witness patient after ten days of treatment with dabigatran. The patient refused to have a blood transfusion due to belief. An endoscopic examination showed diffuse bleeding from her colonic mucosa, which is typical for medical induced bleedings. The patient was in a life-threatening condition and the haemoglobin level fell to nadir 2 mmol/l, before the bleeding stopped after one week's pause of dabigatran therapy. Since an antidote to dabigatran does not exist, precaution is needed when treating patients, who might refuse to have blood transfusion.
authors: Kardiologisk Afsnit, Medicinsk Afdeling, Køge Sygehus, Lykkebækvej 1, 4600 Køge, Denmark. jakobph@hotmail.com
authors: Jakob
authors: J
authors: Holm
authors: Mustafa
authors: M
authors: Taskiran
mesh_terms: D000368:Aged; D000991:Antithrombins / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy; D001562:Benzimidazoles / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D001803:Blood Transfusion / Q000523:psychology; D016638:Critical Illness / Q000628:therapy; D000069604:Dabigatran; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000628:therapy; D006801:Humans; D033221:Jehovah's Witnesses; D010949:Plasma; D016896:Treatment Outcome; D016312:Treatment Refusal; D015091:beta-Alanine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000991:Antithrombins; D001562:Benzimidazoles; D015091:beta-Alanine; D000069604:Dabigatran