Persistent life-threatening hemorrhage after administration of idarucizumab

Idarucizumab (Praxbind) is approved in the United States for reversal of the non-vitamin K oral anticoagulant dabigatran. In this case report, we describe a patient who experienced persistent lifethreatening gastrointestinal hemorrhage after the administration of idarucizumab. Additional interventions, including emergent angiography and administration of factor eight inhibitor bypassing activity, were provided to stop the bleeding. This case suggests that idarucizumab might not induce adequate clinical hemostasis for lifethreatening hemorrhage in a timely manner despite the correction of abnormal laboratory values.