[Gastrointestinal bleeding during treatment with non­vitamin K antagonist oral anticoagulants (NOACs) may be caused by malignant lesions].
Gastrointestinal bleeding during treatment with non -vitamin K antagonist oral anticoagulants (NOACs) may be caused by malignant lesions Gastrointestinal bleeding due to underlying malignancy may not be uncommon in real life patients on non vitamin K antagonist oral anticoagulants (NOACs) like dabigatran, rivaroxaban or apixaban. We performed a small pilot study in patients referred to endoscopy due to suspected gastrointestinal bleeding. In twenty NOAC-treated patients, we found four cases of manifest malignant colon tumors, one premalignant colon adenoma, and one gastric B-cell lymphoma. All lesions were previously unknown and non-symptomatic apart from suspected gastrointestinal bleeding. Endoscopy should be performed in patients on NOACs with signs or suspicions of gastrointestinal bleeding. Whether a fecal occult blood test should be incorporated in the follow-up of patients on NOAC treatment deserves to be investigated in future studies.
Gastroenheten - Medicinkliniken Stockholm, Sweden Gastroenheten - Medicinkliniken Stockholm, Sweden.
Anna
A
Haeggström
Endoskopienheten - Kirurgkliniken Danderyds Sjukhus Stockholm, Sweden Endoskopienheten - Kirurgkliniken Danderyds Sjukhus Stockholm, Sweden.
Dag
D
Risberg
Stockholm Heart Center - Stockholm, Sweden Stockholm Heart Center - Stockholm, Sweden.
Faris
F
Al-Kahlili
Endoskopienheten - Kirurgkliniken Danderyds Sjukhus Stockholm, Sweden Endoskopienheten - Kirurgkliniken Danderyds Sjukhus Stockholm, Sweden.
Åsa
Å
Gilstring
Endoskopienheten - Kirurgkliniken Danderyds Sjukhus Stockholm, Sweden Endoskopienheten - Kirurgkliniken Danderyds Sjukhus Stockholm, Sweden.
Ulrika
U
Tullberg
Inst för kliniska vetenskaper - Hjärtkliniken Stockholm, Sweden Inst för kliniska vetenskaper - Hjärtkliniken Stockholm, Sweden.
Håkan
H
Wallén
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D000991:Antithrombins / Q000009:adverse effects*; D003113:Colonoscopy; D000069604:Dabigatran / Q000009:adverse effects*; D065427:Factor Xa Inhibitors / Q000009:adverse effects*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis; D005770:Gastrointestinal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011720:Pyrazoles / Q000009:adverse effects*; D011728:Pyridones / Q000009:adverse effects*; D012307:Risk Factors; D000069552:Rivaroxaban / Q000009:adverse effects*; D014812:Vitamin K / Q000037:antagonists & inhibitors
D000925:Anticoagulants; D000991:Antithrombins; D065427:Factor Xa Inhibitors; D011720:Pyrazoles; D011728:Pyridones; D014812:Vitamin K; C522181:apixaban; D000069552:Rivaroxaban; D000069604:Dabigatran