The Drug-Induced Respiratory Disease Website

Rivaroxaban

Hematoma of/around central airway wall potentially causing UAO

UAO: upper airway obstruction. Hematoma may localize in the mouth floor, tongue, retropharyngeal space, epiglottis, airway wall or localize in the mediastinum around the airway potentially causing UAO

Publications

Abukhder M, Hulme J, Nathoo S, Shubhi S

Spontaneous retropharyngeal haematoma with direct oral anticoagulant medication.

BMJ case reports 2021 May 13;14; — 2021 May 13

Vierendeels C, Peeters X, Bosschaert P

Retropharyngeal Hematoma under Rivaroxaban: A Rare Entity to Know for Its Risk of Airway Obstruction.

Journal of the Belgian Society of Radiology 2021 Mar 16;105;15 — 2021 Mar 16 — 15

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

Diagnosing DIRD

Identify causative drugs

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