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Svær dabigatranintoksikation kompliceret af utilstrækkelig reversering ved idarucizumab

Forfatter(e)

Maja Hellfritzsch1,2 & Anne-Mette Hvas3,4

1) Hjertesygdomme, Hospitalsenheden Vest

2) Klinisk Farmakologisk Afdeling, Aarhus Universitetshospital

3) Klinik for Koagulation, Blodprøver og Biokemi, Aarhus Universitetshospital

4) Forskningsenheden for Trombose og Hæmostase, Institut for Klinisk Medicin, Health, Aarhus Universitet

Ugeskr Læger 2020;182:V12190706

Reference: 
UgeskrLæger 2020;182:V12190706
Blad nummer: 
Severe dabigatran intoxication complicated by insufficient reversal by idarucizumab

Maja Hellfritzsch & Anne-Mette Hvas:

Ugeskr Læger 2020;182:V12190706

Despite the emergence of the specific dabigatran antidote idarucizumab, reversal of dabigatran in the context of severe intoxication remains a clinical challenge. We report a case of severe intoxication secondary to acute renal failure in a 65-year-old man with atrial fibrillation. Idarucizumab was administered repeatedly but failed to reverse the effect of dabigatran, most likely due to ongoing redistribution. Full reversal of dabigatran was obtained through continuous haemodialysis over days. Further, secondary to the intoxication, the patient developed parenchymatous acute liver injury.

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