rivaroxaban and Cough

BACKGROUND Several studies have described an increased incidence of venous thromboembolism in inflammatory conditions such as sarcoidosis. CASE REPORT We report a case of a 27-year-old African-American man who developed sarcoidosis with pulmonary involvement after 4 years of unexplained thromboembolism. CONCLUSIONS This report discusses the relationship between sarcoidosis and venous thromboembolism. Our case raises questions about this relationship. Can sarcoidosis lead to an inflammatory and prothrombotic state prior to the development of other manifestations?

Topics: Adult; Anti-Inflammatory Agents; Cough; Diagnosis, Differential; Dyspnea; Factor Xa Inhibitors; Humans; Male; Prednisone; Rivaroxaban; Sarcoidosis; Tomography Scanners, X-Ray Computed; Venous Thromboembolism

Spontaneous rectus sheath haematomas and cough secondary to losartan are individually rare conditions. Abdominal wall haematomas present with abdominal pain and abdominal mass. Most patients are managed conservatively; Surgery or embolisation is indicated for shock, infection, rupture into the peritoneum or intractable pain. This is a man aged 65 years presented with dry cough and right-sided abdominal pain. He started losartan a few weeks prior to the onset of cough and had been on rivaroxaban for prior deep venous thrombosis. The right side of his abdomen was distended, bruised and tender. His haemoglobin dropped from 13.3to 9.5 g/dL. CT abdomen/pelvis showed a large 14.5×9.1×4.5 cm haematoma within the right lateral rectus muscle. His only risk factor for developing rectus sheath haematoma was cough in the setting of anticoagulation. Dry cough due to angiotensin receptor blockers is rare, but can have very serious consequences.

Topics: Aged; Antihypertensive Agents; Cough; Diagnosis, Differential; Factor Xa Inhibitors; Hematoma; Humans; Hypertension; Losartan; Male; Muscular Diseases; Rectus Abdominis; Rivaroxaban; Tomography, X-Ray Computed