Edoxaban Kullanımına Bağlı Spontan Renal Hematom: Olgu Sunumu
Edoxaban faktör Xa'yı doğrudan baskılayan bir oral antikoagülan ilaçtır. Daha az ilaç etkileşimi ve rutin izleme ihtiyacını ortadan kaldırması nedeniyle; inme profilaksisi, venöz tromboemboli profilaksisi/tedavisi, akut koroner sendromların sekonder profilaksisi için hastalara daha iyi tedavi alternatifleri sağlamıştır. Kullanımı arttıkça klinisyenlerin potansiyel tedavi riskleri ve komplikasyon yönetiminden daha fazla haberdar olmaları gerekmektedir. Bu makalede, atriyal fibrilasyon nedenli inme profilaksisi için edoxaban kullanan hastada gelişen spontan renal hematom bildirilmektedir. Hemodinamik destek sağlanan, görüntülemeler ile izlenen ve multidisipliner açıdan tedavi ve takip kararları alınan hasta tüm çabalara rağmen hayatını kaybetti. Kanama pıhtılaşma değerlerini değiştirmedikleri için acil servise başvuran kanamalı hastalarda bu ilaçların kullanım anamnezi dikkatli alınmalıdır. Vakamızda da gösterildiği gibi kullanımları sırasında gelişebilecek ölümcül komplikasyonlar için tedavi algoritmaları geliştirebilmek için daha geniş vaka serilerine ve olgu sunumlarına ihtiyaç vardır.
Edoxaban-related Spontaneous Renal Hematoma: A Case Report
Edoxaban is an oral anticoagulant drug that directly inhibits factor Xa. It is used for stroke prophylaxis, venous thromboembolism prophylaxis / treatment, and secondary prophylaxis of acute coronary syndromes. Drug interactions with edoxaban are rare and there is no need for routine blood monitoring. Clinicians should be more aware of potential complications and complication management, as they are prescribed quite frequently. In this article, a spontaneous renal hematoma in a patient using edoxaban for atrial fibrillation-induced stroke prophylaxis is reported. The treatment and follow-up decisions were made by the multidisciplinary team and the patient died despite all efforts. The use of these drugs should be carefully questioned in patients with bleeding who apply to the emergency room because they do not change the coagulation parameters. Larger case series and case reports are needed to develop treatment algorithms for fatal complications that may occur during their use.
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