A Case of Rivaroxaban-induced Hematomyelia of Thoracic Spinal Cord in Patient with Acute Renal Failure.

NMC case report journal Pub Date : 2024-07-27 eCollection Date: 2024-01-01 DOI:10.2176/jns-nmc.2024-0002
Motoyuki Iwasaki, Ikuma Echizenya, Miki Fujimura
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Abstract

Hematomyelia associated with direct oral anticoagulants (DOACs) is rare. In this report, a case of a 78-year-old male with paraplegia due to hematomyelia after medication of rivaroxaban, which is the first case in which acute renal failure is closely associated with the onset and underwent surgical evacuation is presented. The patient was initially misdiagnosed as a spinal cord infarction, and appropriate therapeutic intervention was not provided. One year later, the patient's symptoms did not improve, he is dependent on a wheelchair for daily activities, and cystostomy was performed. During administration of DOACs, hemorrhagic lesion should be strongly suspected in a patient with acute renal failure.

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一例急性肾衰竭患者利伐沙班诱发的胸椎脊髓脊膜瘤。
与直接口服抗凝药(DOACs)相关的血肌症十分罕见。本报告介绍了一例 78 岁男性患者在服用利伐沙班后因血肌症导致截瘫的病例,这是首例急性肾衰竭与发病密切相关并接受手术切除的病例。患者起初被误诊为脊髓梗死,没有得到适当的治疗干预。一年后,患者症状未见好转,日常活动需要依靠轮椅,于是进行了膀胱造口术。在服用 DOACs 期间,应强烈怀疑急性肾衰竭患者有出血性病变。
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