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. 2015:2015:298261.
doi: 10.1155/2015/298261. Epub 2015 Aug 5.

Dabigatran-Related Nephropathy in a Patient with Undiagnosed IgA Nephropathy

Rachele Escoli  1 , Paulo Santos  1 , Sequeira Andrade  1 , Fernanda Carvalho  2
Affiliations

Dabigatran-Related Nephropathy in a Patient with Undiagnosed IgA Nephropathy

Rachele Escoli et al. Case Rep Nephrol. 2015.

Abstract

Dabigatran is a direct thrombin inhibitor used as an alternative to warfarin for long term anticoagulation. Warfarin-related nephropathy is an increasingly recognized entity, but recent evidence suggests that dabigatran can cause a WRN-like syndrome. We describe a case of a biopsy-proven anticoagulant nephropathy related to dabigatran in a patient with IgA nephropathy and propose that, despite the base glomerular disease, acute kidney injury was due to tubular obstruction by red blood cells and heme-associated tubular injury, and through a mechanism involving inhibition of anticoagulation cascade and barrier abnormalities caused by molecular mechanisms.

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Figures

Figure 1
Figure 1
Prominent interstitial hemorrhage and intratubular casts (haematoxylin/eosin staining, magnification 100x).
Figure 2
Figure 2
Interstitial hemorrhage (Masson's trichrome, magnification 100x).
Figure 3
Figure 3
Direct immunofluorescence showing granular mesangial staining for IgA in the expanded mesangium of the biopsy, magnification 400x.
See this image and copyright information in PMC

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