Rivaroxaban for Management of Venous Thromboembolism in Pediatric Nephrotic Syndrome; a Case Report and Review of Literature.

Edoxaban was effective for treating renal vein thrombosis in a patient with nephrotic syndrome. Recently, rivaroxaban, a direct factor-Xa inhibitor, has been shown to be safe and efficacious in treating children with venous thromboembolism, but has not been well studied in NS.[2] While as an antithrombin-independent anticoagulant, it may offer convenient, effective, and reliable oral anticoagulation in NS, rivaroxaban is primarily protein-bound, and thus its pharmacokinetic properties may be altered in NS.[3] We present a case of an adolescent with NS who experienced a large proximal deep vein thrombosis (DVT) and submassive pulmonary embolism (PE), successfully treated with rivaroxaban. As LMWHs confer their antithrombotic action by inhibition of activated factor X through binding and activating antithrombin, they may not be ideal in patients with antithrombin deficiency including patients with active nephrotic syndrome. Thromboembolism is a well-recognized and potentially life-threatening complication of nephrotic syndrome (NS). [Extracted from the article]

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