In:
TH Open, Georg Thieme Verlag KG, Vol. 03, No. 03 ( 2019-07), p. e306-e308
Abstract:
Idarucizumab is a humanized antigen binding fragment (Fab) of a recombinant anti-dabigatran monoclonal antibody (IgG1-kappa) that allows rapid and sustained reversal of dabigatran-induced anticoagulation in case of bleeding or urgent surgery. Herein, we report a very unusual case of dabigatran reversal by idarucizumab in a 79-year-old woman with acute kidney failure admitted to a hospital in a context of hemoptysis. Three repeated injections were necessary because of massive dabigatran overdose and high rebounds of dabigatran plasma concentration. Idarucizumab was found on urine immunofixation up to 6 days after the last injection where it reacted with anti-kappa light chain antibody, but not with anti-gamma heavy chain antibody. Physicians should be aware of the increased half-life of idarucizumab in this context of acute kidney impairment and of its interference with urine immunofixation because it could lead to false-positive results and misdiagnosis of a paraprotein.
Type of Medium:
Online Resource
ISSN:
2512-9465
DOI:
10.1055/s-0039-1697642
Language:
English
Publisher:
Georg Thieme Verlag KG
Publication Date:
2019
detail.hit.zdb_id:
2893939-6