Leukocytoclastic vasculitis associated with rivaroxaban

Sainz‐Gaspar, Laura; Veiga, Gabriela Pita da; Suárez-Peñaranda, José Manuel; Vázquez‐Veiga, Hugo; Sánchez‐Aguilar, D.

doi:10.1111/ijd.13952

Cited by 10 publications

(4 citation statements)

References 10 publications

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“…Of note, a 3-day course of high dose intravenous immunoglobulins probably contributed to rapid improvement of platelet count. Rivaroxaban was also considered responsible of four cases of leukocytoclastic vasculitis (14,15,16,17) which developed respectively 4, 7, 10 and approximately 90 days after the start of anticoagulation. Common characteristics were the appearance of purpuric papules with diffuse distribution and in particular involving the limbs, symmetrically.…”

Section: Resultsmentioning

confidence: 99%

Hypersensitivity reactions to non-vitamin K oral anticoagulants - a review of literature and diagnostic work-up proposal

Carli

Farsi

Chiarini

et al. 2019

Eur Ann Allergy Clin Immunol

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Non-vitamin K antagonist oral anticoagulants (NOACs) are increasingly being used in hospital and outpatient settings as safe alternatives to warfarin. Hypersensitivity reactions have been described for NOACs and can be classified according to Gell and Coombs. We reviewed case reports of possible drug hypersensitivity reactions, noticing a predominance of delayed reactions (both mild and severe) and the absence of cross-reactions to warfarin and low molecular weight heparins. International experience on diagnostic tests is lacking. The vast majority of authors refer to probability scores and rely on biopsy to classify vasculitis and rule out differential diagnoses. We propose to adapt available tests to confirm the patient's reactivity to new anticoagulants. Among in vivo tests, patch testing revealed promising in delayed reactions.

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Section: Resultsmentioning

confidence: 99%

Hypersensitivity reactions to non-vitamin K oral anticoagulants - a review of literature and diagnostic work-up proposal

Carli

Farsi

Chiarini

et al. 2019

Eur Ann Allergy Clin Immunol

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“…As of now, 10 cases have been described on NOAC-induced LCV: one caused by apixaban, 8 four caused by dabigatran [9][10][11][12] and five caused by rivaroxaban. [12][13][14][15][16] No cases have been located for edoxaban, but this might be due to limited time-availability, as edoxaban only has been marketed since 2015. 17 Only one case has described how the patient developed LCV on apixaban, but did not develop LCV after administration of rivaroxaban.…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…All abstracts were read, and 9 articles were found on NOACinduced LCV. [8][9][10][11][12][13][14][15][16] All published cases and the development of cases are listed in Table 1.…”

Section: Literature Reviewmentioning

confidence: 99%

Apixaban-induced leukocytoclastic vasculitis

Esbech¹,

Schmidt

Andersen

et al. 2020

Adverse Drug Reaction Bulletin

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Introduction: Drug-induced vasculitis is a rare adverse drug reaction and the potential to induce such a reaction is often established postmarketing. Leukocytoclastic vasculitis -a subtype of drug-induced vasculitis -often presents itself with palpable purpuric lesions, and often within weeks of initial administration. Case-description: We present a 62-year-old male who presented with leukocytoclastic vasculitis within the first 8 days of apixaban-initiation. Symptoms improved upon discontinuation and resolved after several months of prednisone therapy. Literature review: We conducted a search on PubMed, which yielded 10 reports of leukocytoclastic vasculitis induced by NOACs, of these 10 only 1 had been caused by apixaban, 4 caused by dabigatran and 5 had been caused by rivaroxaban. Of these cases, one presented with leukocytoclastic vasculitis induced by both rivaroxaban and dabigatran, and one case presented successful switch from apixaban to rivaroxaban. Conclusion: Apixaban-induced leukocytoclastic vasculitis is a rare but serious and important adverse reaction.

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“…NOACs, including rivaroxaban and dabigatran, have been widely used as warfarin alternatives, because of their efficacy and safety. Rivaroxaban- and dabigatran-associated LCV have previously separately been reported in some patients each [[12], [13], [14], [15], [16], [17], [18], [19]]. They emphasize that clinicians should be aware of this rare but important adverse effect because of the increased use of these NOACs.…”

Section: Discussionmentioning

confidence: 99%

Case of both rivaroxaban- and dabigatran-induced leukocytoclastic vasculitis, during management of pulmonary thromboembolism

Lee

Kim

et al. 2019

Respiratory Medicine Case Reports

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Leukocytoclastic vasculitis is a disorder characterized by neutrophilic inflammation that is predominantly limited to the superficial cutaneous postcapillary venules. This condition may be idiopathic or may have a defined cause. Rivaroxaban and dabigatran have been widely used as warfarin alternatives, because of their efficacy and safety. In this case report, we describe a case of leukocytoclastic vasculitis induced by both rivaroxaban- and dabigatran-, which developed during the management of pulmonary thromboembolism.

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Leukocytoclastic vasculitis associated with rivaroxaban

Cited by 10 publications

References 10 publications

Hypersensitivity reactions to non-vitamin K oral anticoagulants - a review of literature and diagnostic work-up proposal

Hypersensitivity reactions to non-vitamin K oral anticoagulants - a review of literature and diagnostic work-up proposal

Apixaban-induced leukocytoclastic vasculitis

Case of both rivaroxaban- and dabigatran-induced leukocytoclastic vasculitis, during management of pulmonary thromboembolism

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