Multiple-site bleeding with prominent rise in coagulation tests in an elderly woman using dabigatran etexilate

Dabigatran etexilate is a novel oral anticoagulant, which inhibits thrombin directly and offers an alternative to warfarin in atrial fibrillation (AF) (1-4). Dabigatran does not require routine blood testing or dose adjustments. However, increasing number of case reports show that dabigatran may change prothrombin time (PT) or activated partial thromboplastin time (aPTT) with clinical bleeding (5, 6). We, herein, report an elderly female who presented with multiple site bleeding and a dramatic increase in PT shortly after starting dabigatran.