Inhaled Tranexamic Acid for Non-Massive Haemoptysis in a Rivaroxaban-Receiving Patient Not Responding to the Oral Form.

Unlabelled: Haemoptysis is the expectoration of blood originating from the respiratory tract and occurs secondary to infection, malignancy, bronchiectasis or vascular disease. Its severity varies from minimal blood-streaked sputum to life-threatening haemorrhage. Therefore, prompt evaluation of the cause of the haemoptysis and its severity, and timely management are crucial. Although there is still no effective therapy for haemoptysis apart from treating the cause, inhaled tranexamic acid (TXA) might have a potential role in controlling non-massive haemoptysis. Here, we present a case of non-massive haemoptysis in a COPD patient with bronchiectasis on rivaroxaban for atrial fibrillation who responded to inhaled TXA following a failed trial of the oral formulation.

Learning Points: Haemoptysis is the expectoration of blood and has several causes including bronchitis, bronchiectasis and bronchial neoplasms; severity ranges from simple blood-streaking of sputum to massive blood without sputum.Early recognition of haemoptysis, identification of the cause, and controlling it are crucial, especially in patients on anti-coagulation medicine.Inhaled tranexamic acid has shown benefit in controlling bleeding in patients with non-massive haemoptysis.