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Poor response to rivaroxaban in nephrotic syndrome with acute deep vein thrombosis: A case report
RATIONALE: Hypercoagulability can lead to thromboembolic events that are a life-threatening complication of nephrotic syndrome (NS). Conventional anticoagulants are first-line treatment in the presence of demonstrated thrombosis in NS. Direct-acting oral anticoagulants (DOACs) have provided useful a...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709193/ https://www.ncbi.nlm.nih.gov/pubmed/31374026 http://dx.doi.org/10.1097/MD.0000000000016585 |
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author | Li, Yan Chen, Yikuan Qi, Xiaotong Hu, Bangqin Du, Qingqing Qian, Yan |
author_facet | Li, Yan Chen, Yikuan Qi, Xiaotong Hu, Bangqin Du, Qingqing Qian, Yan |
author_sort | Li, Yan |
collection | PubMed |
description | RATIONALE: Hypercoagulability can lead to thromboembolic events that are a life-threatening complication of nephrotic syndrome (NS). Conventional anticoagulants are first-line treatment in the presence of demonstrated thrombosis in NS. Direct-acting oral anticoagulants (DOACs) have provided useful alternatives for the prevention and treatment of thromboembolic events. PATIENT CONCERNS: A 59-year-old male developed lower limbs deep vein thrombosis (DVT) during the early course of NS but presented poor response to oral therapeutic doses of rivaroxaban. The decision was made to switch from rivaroxaban to heparin and subsequently bridged to warfarin. The patient presented significant clinical symptom improvement. DIAGNOSIS: NS with Lower limbs DVT. INTERVENTIONS: Rivaroxaban was discontinued and switch to heparin and subsequently bridged to warfarin. OUTCOMES: Venography result of both lower limb vein showed the venous wall was smooth without obvious stenosis or obstruction. Edema of the patient's lower limbs gradually improved and disappeared. LESSONS: The existing published data on the application of DOACs in NS are limited. DOACs have an immediate anticoagulant effect and have demonstrated safety and efficacy and required no routine monitoring, however, application of these agents in NS likely requires further investigation before widespread adoption. |
format | Online Article Text |
id | pubmed-6709193 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-67091932019-10-01 Poor response to rivaroxaban in nephrotic syndrome with acute deep vein thrombosis: A case report Li, Yan Chen, Yikuan Qi, Xiaotong Hu, Bangqin Du, Qingqing Qian, Yan Medicine (Baltimore) Research Article RATIONALE: Hypercoagulability can lead to thromboembolic events that are a life-threatening complication of nephrotic syndrome (NS). Conventional anticoagulants are first-line treatment in the presence of demonstrated thrombosis in NS. Direct-acting oral anticoagulants (DOACs) have provided useful alternatives for the prevention and treatment of thromboembolic events. PATIENT CONCERNS: A 59-year-old male developed lower limbs deep vein thrombosis (DVT) during the early course of NS but presented poor response to oral therapeutic doses of rivaroxaban. The decision was made to switch from rivaroxaban to heparin and subsequently bridged to warfarin. The patient presented significant clinical symptom improvement. DIAGNOSIS: NS with Lower limbs DVT. INTERVENTIONS: Rivaroxaban was discontinued and switch to heparin and subsequently bridged to warfarin. OUTCOMES: Venography result of both lower limb vein showed the venous wall was smooth without obvious stenosis or obstruction. Edema of the patient's lower limbs gradually improved and disappeared. LESSONS: The existing published data on the application of DOACs in NS are limited. DOACs have an immediate anticoagulant effect and have demonstrated safety and efficacy and required no routine monitoring, however, application of these agents in NS likely requires further investigation before widespread adoption. Wolters Kluwer Health 2019-08-02 /pmc/articles/PMC6709193/ /pubmed/31374026 http://dx.doi.org/10.1097/MD.0000000000016585 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 |
spellingShingle | Research Article Li, Yan Chen, Yikuan Qi, Xiaotong Hu, Bangqin Du, Qingqing Qian, Yan Poor response to rivaroxaban in nephrotic syndrome with acute deep vein thrombosis: A case report |
title | Poor response to rivaroxaban in nephrotic syndrome with acute deep vein thrombosis: A case report |
title_full | Poor response to rivaroxaban in nephrotic syndrome with acute deep vein thrombosis: A case report |
title_fullStr | Poor response to rivaroxaban in nephrotic syndrome with acute deep vein thrombosis: A case report |
title_full_unstemmed | Poor response to rivaroxaban in nephrotic syndrome with acute deep vein thrombosis: A case report |
title_short | Poor response to rivaroxaban in nephrotic syndrome with acute deep vein thrombosis: A case report |
title_sort | poor response to rivaroxaban in nephrotic syndrome with acute deep vein thrombosis: a case report |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709193/ https://www.ncbi.nlm.nih.gov/pubmed/31374026 http://dx.doi.org/10.1097/MD.0000000000016585 |
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