- 著者
- Tomoki Taniguchi Mayumi Tomita Hiroyuki Ikeda Ryo Kamimatsuse Kojiro Yamamoto Ai Shimizu Yuko Yanai Tadashi Kamata Noriyuki Iehara
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.60, no.21, pp.3453-3458, 2021-11-01 (Released:2021-11-01)
- 参考文献数
- 23
- 被引用文献数
- 1
A 73-year-old woman with atrial fibrillation treated with rivaroxaban was hospitalized for nephrotic syndrome. After discontinuation of rivaroxaban to lower the risk of hemorrhagic events, a renal biopsy was performed. Rivaroxaban was scheduled to resume a week after the biopsy to prevent renal hemorrhaging. However, she developed acute brachial arterial embolic occlusion and mural thrombosis in the abdominal aorta before resuming rivaroxaban. If immune-mediated renal diseases are suspected in anticoagulated patients at a risk of thrombotic events, physicians should consider initiating glucocorticoid therapy without a renal biopsy in order to avoid hemorrhagic and thrombotic events.
- 著者
- Tomoki Taniguchi Yuta Inoue Mitsuru Itoh Mayumi Tomita Tadashi Kamata Noriyuki Iehara
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.60, no.11, pp.1737-1742, 2021-06-01 (Released:2021-06-01)
- 参考文献数
- 29
- 被引用文献数
- 2
A patient with recurrent plasmacytoma with massive ascites exhibited vancomycin intoxication and cefepime-induced encephalopathy due to renal dysfunction. The ascitic accumulation of these drugs was suspected because of the refractory intoxicated state. To remove these drugs that had accumulated in the blood and ascites, abdominal drainage was performed in addition to online hemodiafiltration. If patients with renal dysfunction and massive ascites develop vancomycin intoxication and cefepime-induced encephalopathy that cannot be improved by drug discontinuation, physicians should suspect ascitic accumulation and evaluate the ascitic concentration. Furthermore, if a high accumulation in massive ascites occurs, physicians should perform abdominal drainage along with blood purification.