Reactions Weekly | 2021
Rivaroxaban
Abstract
Diffuse alveolar haemorrhage: case report A 43-year-old woman developed diffuse alveolar haemorrhage following treatment with rivaroxaban for deep vein thrombosis*. The woman presented with shortness of breath and frank haemoptysis. She had a significant medical history of tobacco use disorder and hyperlipidaemia. She had been diagnosed with lower extremity deep vein thrombosis and was initiated on a direct oral anticoagulant treatment with oral rivaroxaban [dosage not stated]. One month after rivaroxaban treatment, she presented with the current condition. Her haemoglobin was dropped from 14 to 7 g/dL. Therefore, she was treated with two units of blood. She was also administered prothrombin complex concentrate. A CT angiogram of the chest revealed bilateral lung fields along with patchy ground-glass opacities with peripheral sparing, without significant intra-lobular septal thickening and no pulmonary embolus. Rheumatological and infectious workup was negative. A bronchoscopy confirmed the diagnosis of diffuse alveolar haemorrhage secondary to rivaroxaban. The woman’s treatment with rivaroxaban was discontinued. Subsequently, haemoptysis resolved. The lower extremity dopplers results were negative for deep vein thrombosis. Subsequently, she was discharged without anticoagulation.