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Case Reports
. 2017 Nov 1;56(21):2913-2917.
doi: 10.2169/internalmedicine.8666-16. Epub 2017 Sep 25.

Aortic Aneurysm-associated Disseminated Intravascular Coagulation that Responded Well to a Switch from Warfarin to Rivaroxaban

Yasuko Kadohira  1 , Shinya Yamada  1 , Erika Matsuura  1 , Tomoe Hayashi  1 , Eriko Morishita  1 , Shinji Nakao  1 , Hidesaku Asakura  1
Affiliations
Case Reports

Aortic Aneurysm-associated Disseminated Intravascular Coagulation that Responded Well to a Switch from Warfarin to Rivaroxaban

Yasuko Kadohira et al. Intern Med. .

Abstract

We describe a case in which uncontrolled chronic disseminated intravascular coagulation (DIC) caused by an aortic aneurysm that was exacerbated by chemotherapy for lung cancer, showed dramatic improvement when warfarin, which was being administered for atrial fibrillation, was replaced by rivaroxaban, a direct oral anticoagulant (DOAC). The present case is interesting because a DOAC was effective in treating DIC due to an aortic aneurysm, whereas warfarin, another oral anticoagulant, was ineffective. In controlling DIC, it is important to inhibit activated coagulation factors such as thrombin and activated factor X, rather than the coagulation factors, which act as substrates.

Keywords: aortic aneurysm; direct oral anticoagulant; disseminated intravascular coagulation; fibrinolytic activation; rivaroxaban.

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Figures

Figure 1.
Figure 1.
The changes in the platelet counts and fibrinogen levels during warfarin treatment.
Figure 2.
Figure 2.
The clinical course of anticoagulant therapy and the changes in coagulation and fibrinolytic markers. Fbg<50 mg/dL. Day 0 indicates the day on which rivaroxaban treatment was initiated. Fbg: fibrinogen, FDP: fibrin/fibrinogen degradation products, TAT: thrombin antithrombin complex, PAP: plasmin-α2-antiplasmin complex, α2-AP: α2-antiplasmin
See this image and copyright information in PMC

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