Severe obscure gastrointestinal bleeding successfully treated with idarucizumab

Rev Esp Enferm Dig. 2018 Apr;110(4):264-265. doi: 10.17235/reed.2018.5298/2017.

Abstract

Idarucizumab is a monoclonal antibody that rapidly reverses the anticoagulant effect of dabigatran. The experience with this drug in the setting of gastrointestinal bleeding is scarce. We present the case of an 84-year-old male with known history of non-valvular atrial fibrillation anticoagulated with dabigatran who presented to the emergency room with melena. During his stay in the emergency department he suddenly worsened with hemodynamic derangement and massive melena so idarucizumab was administered. Gastroscopy and colonoscopy were performed without identifying a bleeding source. After the administration of idarucizumab, the patient did not presented signs of ongoing bleeding. Anticoagulation was resumed on the sixth day and no rebleeding or thromboembolic events have been recorded after six months of follow-up. This case and the limited information available in the literature suggest that idarucizumab can be useful and safe in cases of severe gastrointestinal bleeding with recent intake of dabigatran.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Anticoagulants / adverse effects
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / drug therapy
  • Dabigatran / adverse effects
  • Gastrointestinal Hemorrhage / chemically induced
  • Gastrointestinal Hemorrhage / drug therapy*
  • Humans
  • Male

Substances

  • Antibodies, Monoclonal, Humanized
  • Anticoagulants
  • idarucizumab
  • Dabigatran