Dabigatran Reversal with Idarucizumab in an Emergency Lumbar Puncture: A Case Report.
INTRODUCTION
The widespread use of direct oral anticoagulants (DOACs) has been increasing the conditions in which emergency physicians are forced to rapidly reverse anticoagulation in case of life-threatening bleeding or need of urgent surgery or invasive procedures. The recent approval of Idarucizumab, a humanized monoclonal antibody fragment (Fab), offered the opportunity to rapidly and safely neutralize the anticoagulant effect of Dabigatran. However, real-world experience of its effective use in different emergency setting is now required. Lumbar Puncture (LP) is recognized as an invasive procedure at major bleeding risk and is, therefore, contraindicated in anticoagulated patients.


CONCLUSION
We report a successful use of Idarucizumab in an emergency LP of a young woman with a possible diagnosis of encephalitis and a previous history of venous thromboembolism on long-term treatment with Dabigatran 150 mg twice a day.
['Spagnolello|Ornella|O|', 'Letteri|Federica|F|', 'Falcou|Anne|A|', 'Cipollone|Lorena|L|', 'De Michele|Manuela|M|', 'Bertazzoni|Giuliano|G|', 'Toni|Danilo|D|']
D000328:Adult D061067:Antibodies, Monoclonal, Humanized D000991:Antithrombins D000069604:Dabigatran D004632:Emergency Medical Services D005260:Female D006470:Hemorrhage D006801:Humans D013129:Spinal Puncture
dabigatran idarucizumab emergency lumbar puncture Direct oral anticoagulants reversal emergency department urgent invasive procedures.