Pituitary apoplexy during treatment with dabigatran

Pituitary apoplexy is known as an uncommon complication of pituitary adenoma, and anticoagulant therapy has been reported as one of the precipitating factors. We report an 85‐year‐old man who developed pituitary apoplexy during treatment with dabigatran. His medical history included a non‐functioning pituitary adenoma and non‐valvular atrial fibrillation. Headache occurred 4 days after changing the anticoagulant from warfarin to dabigatran; and other neurological symptoms, such as ptosis and ophthalmoplegia, subsequently developed. On admission, laboratory examination showed a prolonged activated partial thromboplastin time and moderately decreased kidney dysfunction. Emergency magnetic resonance imaging ( MRI) showed pituitary hemorrhage in the tumor. Although dabigatran was reported to cause intracranial hemorrhage less commonly than warfarin, it could cause uncommon bleeding like in the present case.