Accidental Rivaroxaban Intoxication in a 25-month-old Child Monitored by Thromboelastography: A Case Report.

Rivaroxaban is an oral, selective, direct-acting factor Xa inhibitor with high affinity for the active site of factor Xa. Thromboelastography (TEG® 6s) has reportedly been used to evaluate coagulation function under rivaroxaban administration, especially in the perioperative period. To date, there are no reports in the literature about thromboelastography in children that have ingested a large amount of rivaroxaban. We describe the case of a 25-month-old girl who accidentally ingested a large dose of rivaroxaban and we followed up on the coagulation performance with TEG® 6s. When she came to our emergency room, there was no apparent bleeding. The patient was hospitalized for observation while undergoing monitoring using TEG® 6s. Approximately 20 h after taking the medication, all values of her blood tests including TEG® 6s returned to the normal range and the patient was discharged, without evidence of bleeding. This case highlights the potential usefulness of TEG® 6s for evaluating the effects of rivaroxaban in pediatric accidental ingestion.