Massive thrombosis and phlegmasia cerulea dolens while taking rivaroxaban: case report and review

• Autor(a) principal: Chemello,Diego
• Data de Publicação: 2021
• Outros Autores: Rosa,Larissa, Araujo,Amanda Faria de, Araujo,Pedro Cargnelutti de, Pereira,Luiz Carlos Carneiro, Hillesheim,Suélen Feijó, Saffi,Marco Aurélio Lumertz
• Tipo de documento: Relatório
• Idioma: eng
• Título da fonte: Jornal Vascular Brasileiro (Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-54492021000100607
• topic: anticoagulants; venous thrombosis; sinus thrombosis, intracranial

Abstract Our study describes a fatal case of phlegmasia cerulea dolens and massive venous thrombosis in a patient taking rivaroxaban regularly to treat cerebral venous sinus thrombosis. Blood tests samples were positive for lupus anticoagulant. The unique evolution of the case, as well as the positivity for lupus anticoagulant, raises the possibility of an acquired hypercoagulation syndrome. We highlight the fact that the test recommended as the first line for lupus anticoagulant diagnosis (dilute Russell viper venom time) is the most affected by rivaroxaban, leading to a high prevalence of false-positive results. We also discuss potential diagnoses for the current case and review the current state-of-the-art of use of the novel oral anticoagulation agents in this unusual situation. So far, there are no recommendations to use such agents as first options in cerebral venous sinus thrombosis or in hypercoagulation syndromes.