Severe Urinary Bleeding Due to High INR and aPTT After Use of Dabigatran: A Case Report

In recent years, new oral anticoagulant drugs have been used frequently instead of warfarin in the treatment of atrial fibrillation (AF). Although these drugs have similar anticoagulant effects to warfarin, bleeding is less common. Dabigatran is the first of these drugs. Bleeding that may occur after the use of dabigatran is an important undesirable consequence. Bleeding can be major or minor in clinical practice. The incidence of bleeding increases with age. A 93-year-old male patient was admitted to the emergency department with severe urinary bleeding. He was using dabigatran for atrial fibrillation (AF). It was observed that the patient’s aPTT (activated partial thromboplastin time) and INR (international normalized ratio) levels in the emergency department were high. Since there was no cause for bleeding in this patient, it was thought that the bleeding was due to dabigatran. Hemodialysis and/or antidote giving are known in treatment for bleeding after dabigatran. In this case, our aim is to explain that bleeding control can be achieved by giving conservative treatments (general supportive treatment and blood products) to the patient apart from the treatment methods mentioned.