Successful treatment with rivaroxaban for an acute pulmonary thromboembolism in a patient with primary antiphospholipid antibody syndrome

A 73-year-old man was admitted with sudden onset of dyspnea. Contrast-enhanced computed tomography showed acute pulmonary thromboembolism and deep vein thrombosis. He was started on the direct oral anticoagulant rivaroxaban (factor Xa inhibitor) and this resolved the thrombus. Serological analysis revealed that his risk of thrombosis was primary antiphospholipid syndrome (APS). He has remained free of recurrent venous thromboembolism (VTE) for two years while under rivaroxaban. We present a case with VTE due to APS for whom direct oral anticoagulant was effective.