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Extensive skin necrosis in an elderly woman on dabigatran

Authors :
Raihan Ashraf
Joyita Bharati
Nishtha Ahuja
Arun Prabhahar Rajarajen
Source :
BMJ case reports. 14(10)
Publication Year :
2023

Abstract

Dabigatran, a novel oral anticoagulant, is a direct thrombin inhibitor and is being increasingly used owing to the advantage of dosing without the need for laboratory monitoring. While extensive skin necrosis is known to be associated with oral anticoagulants such as warfarin and factor Xa inhibitors, dabigatran toxicity typically manifests with bleeding, especially in the elderly. We describe a 70-year-old woman who was prescribed dabigatran for the treatment of unprovoked deep venous thrombosis. She developed bleeding diathesis along with extensive skin necrosis and acute kidney injury shortly after commencing the drug. Haemodialysis was given in view of dabigatran toxicity and complications of kidney dysfunction which resolved promptly over a week. However, the patient succumbed to severe sepsis from secondary skin infections. It is crucial to closely monitor for signs of dabigatran toxicity, especially in the elderly patients.

Details

ISSN :
1757790X
Volume :
14
Issue :
10
Database :
OpenAIRE
Journal :
BMJ case reports
Accession number :
edsair.doi.dedup.....78977c710e8e9f40b807e3b382c2c8f4