Successful Treatment with Edoxaban for Disseminated Intravascular Coagulation in a Case of Aortic Dissection Complicated with Immune Thrombocytopenic Purpura

• Published in: Internal Medicine Vol. 59; no. 16; pp. 2035 - 2039
• Main Authors: Uemura, Shun, Kobayashi, Hironori, Seki, Yoshinobu, Okoshi, Yuki, Sone, Hirohito, Nomoto, Nobuhiko
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 15.08.2020; Japan Science and Technology Agency
• Subjects: Aged; Aneurysm, Dissecting - complications; Anticoagulants - therapeutic use; Aorta; Aortic dissection; Atrial Fibrillation - complications; Atrial Fibrillation - drug therapy; Case Report; direct oral anticoagulant; Dissection; Disseminated intravascular coagulation; Disseminated Intravascular Coagulation - complications; Disseminated Intravascular Coagulation - drug therapy; edoxaban; Female; Fibrillation; Humans; Idiopathic thrombocytopenic purpura; Internal medicine; Platelet Count; Prednisolone; Purpura; Purpura, Thrombocytopenic, Idiopathic - complications; Pyridines - therapeutic use; Thiazoles - therapeutic use; Thrombocytopenic purpura; aortic dissection; disseminated intravascular coagulation; direct oral anticoagulant; edoxaban
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.4255-19

A 70-year-old woman was hospitalized for exacerbation of chronic idiopathic thrombocytopenic purpura (ITP) and disseminated intravascular coagulation (DIC) from old aortic dissection. Initially, we increased the dose of prednisolone for ITP. However, her bleeding tendency caused by DIC worsened despite the rapid recovery of her platelet count, and the required amount of fresh-frozen plasma for transfusion increased. The administration of edoxaban for atrial fibrillation led to the marked improvement of her DIC status without serious adverse events. This case suggests that a direct oral anticoagulant may be an effective treatment for DIC caused by aortic dissection.