2026-04-14T08:56:45Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/113592024-06-06T08:39:11Zcom_2072_378070com_2072_378040col_2072_378092

Managing venous thrombosis in a pediatric patient with short bowel and congenital nephrotic syndromes: a case report emphasizing rivaroxaban level monitoring Artaza, Gonzalo Hernández Mata, Carlos F. Pérez Beltrán, Víctor Cabello Ruiz, Vanessa Bosch Schips, Marc Olivera, Pável E. Institut Català de la Salut [Bosch-Schips M, Artaza G, Hernández-Mata C, Olivera Sumire P] Servei d’Hematologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. [Pérez Beltrán V] Servei de Nefrologia Pediàtrica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Cabello Ruiz V] Unitat de Gastroenterologia Pediàtrica, Vall d’Hebron Hospital Universitari, Barcelona, Spain Vall d'Hebron Barcelona Hospital Campus Ronyons - Malalties - Tractament Malalties congènites en els infants Anticoagulants (Medicina) Trombosi - Tractament DISEASES::Cardiovascular Diseases::Vascular Diseases::Embolism and Thrombosis::Thrombosis::Venous Thrombosis Other subheadings::Other subheadings::Other subheadings::/drug therapy CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Hematologic Agents::Anticoagulants DISEASES::Female Urogenital Diseases and Pregnancy Complications::Female Urogenital Diseases::Urologic Diseases::Kidney Diseases::Nephrosis::Nephrotic Syndrome NAMED GROUPS::Persons::Age Groups::Infant ENFERMEDADES::enfermedades cardiovasculares::enfermedades vasculares::embolia y trombosis::trombosis::trombosis venosa Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::usos terapéuticos::fármacos hematológicos::anticoagulantes ENFERMEDADES::enfermedades de los genitales femeninos y complicaciones del embarazo::enfermedades urogenitales femeninas::enfermedades urológicas::enfermedades renales::nefrosis::síndrome nefrótico DENOMINACIONES DE GRUPOS::personas::Grupos de Edad::lactante Anticoagulación; Síndrome del intestino corto; Trombosis Anticoagulació; Síndrome de l'intestí curt; Trombosi Anticoagulation; Short bowel syndrome; Thrombosis Direct Oral Anticoagulants (DOACs) typically exhibit a predictable pharmacokinetic and pharmacodynamic response at a fixed dose, not necessitating monitoring under standard conditions. Yet, in specific clinical scenarios that can impair it, like Congenital Nephrotic Syndrome (CNS) or Short Bowel Syndrome (SBS) due to absorption issues, anti-thrombin III (AT-III) deficiency and non-selective proteinuria, adjusting the dosage to achieve appropriate plasma concentrations could prove beneficial. We report a 3-month-old female with catheter-related jugular thrombosis affected by CNS concomitant to SBS and failure of both treatments with heparin and warfarin, that was switched to dose-adjusted pediatric rivaroxaban. Rivaroxaban was adjusted to reach peak levels between 189 and 419 ng/ml and the lower trough levels between 6 and 87 ng/ml. Increasing doses were needed due to SBS related malabsorption but a complete permeabilization of the vein was achieved without bleeding complications. The use of anti-Xa adjusted rivaroxaban could be an alternative to improve anticoagulation and secondary thromboprophylaxis in pediatric patients SBS and an option to children with CNS. 2024-04-23T06:17:55Z 2024-04-23T06:17:55Z 2024-04-03 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Bosch-Schips M, Artaza G, Hernández-Mata C, Pérez Beltrán V, Cabello Ruiz V, Olivera Sumire P. Managing venous thrombosis in a pediatric patient with short bowel and congenital nephrotic syndromes: a case report emphasizing rivaroxaban level monitoring. Front Pediatr. 2024 Apr 3;12:1385065. 2296-2360 https://hdl.handle.net/11351/11359 10.3389/fped.2024.1385065 38633324 001203766800001 http://hdl.handle.net/11351/11359 eng Frontiers in Pediatrics;12 https://doi.org/10.3389/fped.2024.1385065 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess application/pdf Frontiers Media Scientia