title: Acute thrombocytopenia after initiating anticoagulation with rivaroxaban.
abstract: A 75-year-old man with paroxysmal atrial fibrillation developed a traumatic intracranial hemorrhage during warfarin treatment. The administration of warfarin was stopped and rivaroxaban therapy, a novel oral anticoagulant (NOAC), was started. Immediately, his platelet count decreased to 3.7×10(4) /μL. The platelet count recovered rapidly after cessation of rivaroxaban administration. Development of thrombocytopenia and its rapid recovery was observed again after another administration, and subsequent cessation, of the drug. A diagnosis of rivaroxaban-induced thrombocytopenia was made. The incidence of thrombocytopenia due to NOACs is rare. Careful attention to thrombocytopenia, which is associated with a higher risk for life-threatening bleeding, is therefore necessary during treatment with NOACs.
authors.affiliation: Department of Cerebrovascular Medicine, Neurology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Mima
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Sangatsuda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yasaka
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Wakugawa
authors.forename: Shinji
authors.initials: S
authors.lastname: Nagata
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Okada
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000150:complications*; D006801:Humans; D020300:Intracranial Hemorrhages / Q000139:chemically induced / Q000175:diagnosis; D008297:Male; D009025:Morpholines / Q000009:adverse effects*; D000069552:Rivaroxaban; D020521:Stroke / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D013876:Thiophenes / Q000009:adverse effects*; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D014859:Warfarin / Q000009:adverse effects
chemical_list: D000925:Anticoagulants; D009025:Morpholines; D013876:Thiophenes; D014859:Warfarin; D000069552:Rivaroxaban