Heparin-resistant Thrombosis Due to Homozygous Antithrombin Deficiency Treated With Rivaroxaban: A Case Report. Issue 8 (November 2016)

• Record Type: Journal Article
• Authors: Van Bruwaene, Lore; Huisman, Albert; Urbanus, Rolf T.; Versluys, Birgitta
• Is Part Of: Journal of pediatric hematology/oncology. Volume 38:Issue 8(2016)
• Publication Date: 2016-11
• Subjects: children -- antithrombin deficiency -- Budapest III -- heparin resistance -- rivaroxaban; Pediatric hematology -- Periodicals; Tumors in children -- Periodicals; 618.9215
• DOI: 10.1097/MPH.0000000000000608
• Languages: English
• ISSNs: 1077-4114

Abstract

Abstract : Background: Heparin fulfills its anticoagulant action through activation of antithrombin (AT), and thus thrombosis secondary to AT deficiency can be associated with heparin resistance. Observation: A 12-year-old girl with severe venous thrombosis was referred to us because of undetectable anti-Xa levels despite low-molecular-weight heparin therapy. Laboratory investigations revealed a homozygous AT mutation in the heparin binding site (AT Budapest III). She was subsequently treated with rivaroxaban successfully. Conclusions: Heparin resistance warrants evaluation for AT deficiency. Rivaroxaban may be considered a valid anticoagulant alternative to low-molecular-weight heparin in these patients.