Heparin-resistant Thrombosis Due to Homozygous Antithrombin Deficiency Treated With Rivaroxaban: A Case Report

Lore Van Bruwaene, Albert Huisman, Rolf T Urbanus, Birgitta Versluys

Research output: Contribution to journalArticleAcademicpeer-review

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.

Original languageEnglish
Pages (from-to)658–660
JournalJournal of Pediatric Hematology/oncology
Volume38
Issue number8
DOIs
Publication statusPublished - Nov 2016

Keywords

  • children
  • antithrombin deficiency
  • Budapest III
  • heparin resistance
  • rivaroxaban

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