Coagulopathy and Extremely Elevated PT/INR after Dabigatran Etexilate Use in a Patient with End-Stage Renal Disease

Table 1

Reported cases of dabigatran overdose.

Authors	Year	Age/sex	Dabigatran dose	Reason for anticoagulation	Comorbidities	Complication	Attempted reversal (other than holding dabigatran)	Outcome
Chen et al. [3]	2013	80/M	150 mg orally once a day	Atrial fibrillation	CKD stage 3, hypothyroidism	Hemoptysis	FFP, HD	Bleeding ceased with HD
Fountzilas et al. [4]	2013	82/F	150 mg orally twice a day	Atrial fibrillation	CHF, CAD, HTN, AKI	Dabigatran toxicity (thrombin time >120 sec, aPTT 135 sec)		Toxicity resolved
Lal and Van Heukelom [5]	2012	81/F	150 mg orally once a day	Atrial fibrillation	DM, CKD stage 3, HTN	Surgical site hematoma	FFP, vitamin K	No further bleeding after hematoma evacuation
Lal and Van Heukelom [5]	2012	76/M	150 mg orally twice a day	Atrial flutter	CAD, CHF, HTN	Colonic anastomosis site bleed		No further bleeding
Lal and Van Heukelom [5]	2012	64/F	Unknown	Atrial fibrillation	CAD, Diastolic CHF, CVA, AKI	GI bleed, subclavian catheter insertion site bleed, SAH	FFP, desmopressin, vitamin K, apheresis platelet concentrate, HD	Bleeding stopped, however patient made comfort care due to pneumonia and multiple comorbidities
Lal and Van Heukelom [5]	2012	80/F	150 mg orally twice a day	Atrial fibrillation	CKD stage 3, HTN	SAH, subdural hemorrhages, intragluteal hemorrhage	FFP, HD	Patient made comfort care
Chang et al. [6]	2013	94/M	150 mg orally twice a day	Atrial fibrillation		Fall with large subdural hematoma compressing the right lateral ventricle	Factor VIII inhibitor (FEIBA; Baxter Healthcare Corporation), HD	Clinical improvement with subsequent discharge to a rehabilitation facility
Maddry et al.; [7]	2013	74/M	150 mg orally twice a day	Atrial fibrillation	AKI	GI bleed	FFP, prothrombin complex concentrate, recombinant factor VIIa, HD	Patient died due to sepsis and DIC

CHF: congestive heart failure; CAD: coronary artery disease; HTN: hypertension; DM: diabetes mellitus; AKI: acute kidney injury; CKD: chronic kidney disease; CVA: cerebrovascular attack; FFP: frozen fresh plasma; HD: hemodialysis; DIC: disseminated intravascular coagulation.