Key result
Dabigatran therapy at 220 mg daily was associated with the development of diffuse alveolar hemorrhage in a 78-year-old man, requiring fresh frozen plasma and mechanical ventilation.
Case Report (n=1)
This case highlights the risk of diffuse alveolar hemorrhage as a severe complication of dabigatran therapy, emphasizing the need for early intervention with fresh frozen plasma and mechanical ventilation.
Dabigatran may precipitate alveolar hemorrhage in elderly patients; this single case leaves open true incidence and monitoring needs.
A 78-year-old man with a history of paroxysmal atrial flutter and fibrillation that had been treated with dabigatran for two months was admitted with hemoptysis and dyspnea. Chest radiography and computed tomography (CT) showed bilateral alveolar infiltration (Picture A, B). His coagulation test results revealed a prothrombin time of 97.5 s and an international normalized ratio of 1.42. A diffuse alveolar hemorrhage (DAH) was clinically suspected and subsequently confirmed by the histological findings of hemosiderin-filled macrophages in his bloody bronchoalveolar fluid.
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Yokoi et al. (2012) conducted a case report in Paroxysmal atrial flutter and fibrillation (n=1). Dabigatran was evaluated on Diffuse alveolar hemorrhage. Dabigatran therapy at 220 mg daily was associated with the development of diffuse alveolar hemorrhage in a 78-year-old man, requiring fresh frozen plasma and mechanical ventilation.
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