rivaroxaban and Antithrombin-III-Deficiency

: The incidence of antithrombin III (AT III) deficiency is very rare. The most common complication of AT III deficiency is deep venous thrombosis, which causes a low incidence of intracranial sinus thrombosis. We presented a 31-year-old Chinese woman patient who had a family history of AT III deficiency admitted to our hospital. She had a history of pulmonary embolism. She took rivaroxaban for a long time to prevent thrombosis. After giving birth, she stopped taking the medication for half a year and suffered from drug withdrawal symptoms. Four months after drug withdrawal, she suddenly fell into a coma. After diagnosis, it was found to be caused by a subarachnoid hemorrhage. Finally, she was diagnosed with sagittal and transverse sinus thrombosis. After treatment with mechanical thrombectomy, she fully recovered. In sum, we concluded that mechanical thrombectomy was efficient for AT III deficiency and treating thrombosis.

Topics: Adult; Antithrombin III Deficiency; China; Factor Xa Inhibitors; Female; Humans; Mechanical Thrombolysis; Rivaroxaban; Sinus Thrombosis, Intracranial

A 19-year-old man was referred due to sudden onset of right foot pain and chest discomfort. Contrast-enhanced computed tomography revealed massive thrombi in the right pulmonary artery and femoral vein. The patient's father had experienced multiple recurrences of venous thromboembolism (VTE) and was diagnosed with inherited antithrombin deficiency by a genetic examination. The patient was administered the oral factor Xa inhibitor rivaroxaban (30 mg). After seven days, the thrombus disappeared. Rivaroxaban (15 mg) was continued for 6 months with no recurrence, indicating the efficacy of this factor Xa inhibitor for the treatment and prevention of VTE in patients with antithrombin deficiency.

Topics: Antithrombin III Deficiency; Factor Xa Inhibitors; Humans; Male; Recurrence; Rivaroxaban; Venous Thromboembolism; Young Adult

Antithrombin (AT) deficiency, a rare disorder of the coagulation system, is a serious risk factor for thromboembolism. Approximately 50-90% of patients with AT deficiency develop thromboembolism during their lifetime. In addition, surgery is a major risk factor for thromboembolism in these patients. We herein report the case of a 90-year-old woman with AT deficiency who was safely and successfully managed using rivaroxaban (a direct oral factor Xa inhibitor) during the perioperative period of surgery for right femur fracture. The present case illustrates the effectiveness of rivaroxaban in preventing thromboembolisms due to surgery, even in very elderly patients with antithrombin deficiency. Further investigations are needed to determine the optimal dosage of rivaroxaban.

Topics: Aged, 80 and over; Anticoagulants; Antithrombin III Deficiency; Blood Coagulation; Factor Xa Inhibitors; Female; Humans; Morpholines; Perioperative Period; Rivaroxaban; Thromboembolism; Treatment Outcome

Heparin fulfills its anticoagulant action through activation of antithrombin (AT), and thus thrombosis secondary to AT deficiency can be associated with heparin resistance.. A 12-year-old girl with severe venous thrombosis was referred to us because of undetectable anti-Xa levels despite low-molecular-weight heparin therapy. Laboratory investigations revealed a homozygous AT mutation in the heparin binding site (AT Budapest III). She was subsequently treated with rivaroxaban successfully.. Heparin resistance warrants evaluation for AT deficiency. Rivaroxaban may be considered a valid anticoagulant alternative to low-molecular-weight heparin in these patients.

Topics: Antithrombin III; Antithrombin III Deficiency; Binding Sites; Child; Drug Resistance; Factor Xa Inhibitors; Female; Heparin, Low-Molecular-Weight; Humans; Rivaroxaban; Thrombosis

Topics: Adult; Antithrombin III Deficiency; Asparaginase; Delayed-Action Preparations; Humans; Male; Morpholines; Polyethylene Glycols; Rivaroxaban; Thiophenes; Treatment Outcome; Venous Thrombosis