title: Dabigatran-related leukocytoclastic vasculitis.
abstract: Dabigatran is a non-vitamin K antagonist oral anticoagulant that has been approved for atrial fibrillation and prevention of venous thromboembolism. Its use has been increasing in the USA since serum drug levels do not need monitoring. To date, no significant skin side effects have been reported other than 4 cases of non-specific skin lesion and 2 cases of leukocytoclastic vasculitis (LCV), which is a small vessel inflammatory disease that presents as palpable purpura in lower extremities. We present a man aged 57 years with chronic deep vein thrombosis who developed palpable purpura, petechiae, swelling in lower extremities, torso and distal upper extremities on the third day after dabigatran initiation. The present case highlights the potential risk for LCV with dabigatran use and provides insight into its management.
authors.affiliation: Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
authors.forename: Josiah
authors.initials: J
authors.lastname: An
authors.affiliation: Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.|Division of Hematology, Oncology and Blood and Marrow Transplantation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
authors.forename: Rohan
authors.initials: R
authors.lastname: Garje
authors.affiliation: Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.|Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
authors.forename: Karolyn A
authors.initials: KA
authors.lastname: Wanat
authors.affiliation: Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.|Division of Hematology, Oncology and Blood and Marrow Transplantation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
authors.forename: José Pablo
authors.initials: JP
authors.lastname: Leone
mesh_terms: D000991:Antithrombins / Q000009:adverse effects*; D000069604:Dabigatran / Q000009:adverse effects*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000139:chemically induced* / Q000188:drug therapy; D020246:Venous Thrombosis / Q000188:drug therapy
chemical_list: D000991:Antithrombins; D000069604:Dabigatran