Literature case analysis of novel oral anticoagulants-related leukocytoclastic vasculitis
10.3760/cma.j.cn114015-20200728-00815
- VernacularTitle:新型口服抗凝药相关白细胞碎裂性血管炎文献病例分析
- Author:
Libo SUN
1
;
Yanqing SONG
1
;
Xue HU
1
;
Yanjiao LI
1
Author Information
1. 吉林大学第一医院药学部，长春 130021
- Publication Type:Journal Article
- Keywords:
Anticoagulants;
Vasculitis;
Rivaroxaban;
Dabigatran;
Apixaban;
Novel oral anticoagulants;
Leukocytoclastic vasculitis
- From:
Adverse Drug Reactions Journal
2021;23(1):25-29
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical characteristics of novel oral anticoagulants (NOAC)-related leukocytoclastic vasculitis (LCV).Methods:PubMed, Embase, ScienceDirect, Ovid, and Scopus databases were searched as of August 2020 and case reports on NOAC-related LCV were collected. Relevant information in patients including gender, age, primary disease, co-existing disease, NOAC application, combined medication, LCV occurrence, treatment and outcome of LCV, and etc. was extracted and analyzed using descriptive statistical method.Results:A total of 13 patients were collected; 6 were from the United States, 2 from Turkey, 2 from Spain, and 3 from Greece, South Korea, and Denmark, respectively. There were 8 males and 5 females, aged 29 to 95 years, and 9 patients were ≥60 years old. Apixaban was applied in 5 patients, rivaroxaban in 5 patients, and dabigatran etexilate in 3 patients. Dose of NOAC was recorded in 7 patients, all of which were within the recommended range of the instructions. Time from taking NOAC to the occurrence of LCV was recorded in 12 patients, ranging from 3-18 days (7-10 days in 7 patients) after the first medication. All 13 patients developed skin lesions, presenting as purpura and/or rash. Skin lesions involved limbs and trunk in 4 patients, lower limbs in 7 patients, lower limbs and trunk in 1 patient, and upper limbs and trunk in 1 patient. Twelve patients underwent skin biopsy at the lesion site; 11 patients had neutrophil infiltration and 1 had only eosinophil infiltration. NOAC was stopped in all the 13 patients after diagnosis of LCV. Among them, other anticoagulants were switched in 12 patients and glucocorticoids were given in 9 patients. Finally, 8 were cured and 5 were improved.Conclusions:NOAC-related LCV usually occurred 7-10 days after the first medication, mainly manifested as purpura and rash and often involved the lower extremities. The prognosis was good after drug withdrawal and appropriate application of glucocorticoid according to patient conditions.
