Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 16, 2022; 10(8): 2537-2542
Published online Mar 16, 2022. doi: 10.12998/wjcc.v10.i8.2537
Idarucizumab reverses dabigatran-induced anticoagulation in treatment of gastric bleeding: A case report
Yu Jia, Shao-Hua Wang, Na-Juan Cui, Quan-Xi Liu, Wei Wang, Xue Li, Ya-Mei Gu, Yan Zhu
Yu Jia, Shao-Hua Wang, Na-Juan Cui, Quan-Xi Liu, Wei Wang, Xue Li, Yan Zhu, Department of Gastroenterology, Hospital of Integrated Traditional Chinese and Western Medicine, Beijing 100039, China
Ya-Mei Gu, Department of General Practice, Tiancun Community Health Service Centre, Beijing 100049, China
Author contributions: Jia Y and Zhu Y wrote and modified the manuscript; Wang SH performed the gastroscopy, confirmed the report, and provided the figures; Wang W and Li X collected the data; Cui N participated in the patient treatment; Zhu Y and Liu QX connected us to the pharmaceutical factory and purchased the idarucizumab; Gu YM and Wang SH reviewed the paper and provided suggestions for the revision; all authors have read and approved the final manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We declare that we do not have any commercial or associative interest that represents a conflict of interest in connection with the work submitted.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan Zhu, MS, Attending Doctor, Department of Gastroenterology, Hospital of Integrated Traditional Chinese and Western Medicine, No. 3 East Yongding Road, Haidian District, Beijing 100039, China. zy815925@163.com
Received: August 15, 2021
Peer-review started: August 15, 2021
First decision: October 20, 2021
Revised: October 30, 2021
Accepted: January 27, 2022
Article in press: January 27, 2022
Published online: March 16, 2022
Core Tip

Core Tip: The anticoagulatory effect of dabigatran resolves completely after five half-lives, which is approximately 2.5-3.5 d after the last dose for patients with normal renal function. Thrombin time (TT) is sensitive to the effects of dabigatran and can be prolonged even with trivial amounts of the drug. This patient exhibited persistent bleeding in the normal coagulation test (except for TT), possibly due to the anticoagulatory effects of the drug administered 4 days after the last dose for her renal insufficiency. Therefore, idarucizumab was administered for hemostasis, thus stopping the bleeding. This case highlights the importance of regular monitoring of renal function in older patients.