Guidance for diagnosis and treatment of disseminated intravascular coagulation from harmonization of the recommendations from three guidelines

Wada, Hideo; Thachil, Jecko; M, Di Nisio; Mathew, Prasad; Kurosawa, Shinichiro; Gando, Satoshi; Hk, Kim; Jd, Nielsen; Ce, Dempfle; Levi, Marcel; Ch, Toh

doi:10.1111/jth.12155

Cited by 398 publications

(343 citation statements)

References 49 publications

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“…[5,6] There is controversy about the moment to iniciate chemotherapy due to the haematological disorders involving DIC, but treating the underlying cause is crucial in the evolution of the coagulopathy. [5,14] In our patient we were in a stage of hormone sensitivity unlike most cases in the literature. The early diagnosis allowed us to start treatment with bicalutamide and LHRH analogues solving DIC and further initiation of chemotherapy.…”

Section: Discussionmentioning

confidence: 67%

“…[12][13][14] There is an increased fibrinolysis in areas of thrombus formation and release of fibrin degradation products. It generates predisposition to both bleeding and thrombogenesis with potential further organ damage being the kidneys the most frequently affected (25%-40%).…”

Section: Discussionmentioning

confidence: 99%

“…It could also be chronic or subclinic, mainly manifested as thrombotic events. [14] Acute DIC represents a diagnostic challenge. The identification of the underlying process is crucial for its management.…”

Section: Discussionmentioning

confidence: 99%

“…[14] In general platelets transfusion are recommended when blood counts are < 50,000/microL and there is a severe bleeding, or under 10,000/microL due to the risk of spontaneous bleeding. Blood red cell transfusions are also recommended when secondary anemia appears.…”

Section: Discussionmentioning

confidence: 99%

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Intravascular disseminated coagulopathy as a debut of metastatic prostate cancer: A case report

Olarte

Unceta

Kopp

et al. 2017

JST

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Hormonal therapy has been the treatment axis of metastatic prostate cancer since 1940. Identifying rare forms of debut is important in order to initiate the best treatment as soon as possible. Intravascular disseminated coagulopathy (DIC) related to prostate cancer is mostly presented as chronic forms. Acute forms can also be the way of presentation, recognizing them is crucial due to its life threatening nature. Here, we present a case of debut of metastatic prostate cancer as an acute DIC. Reporting this case is important because of the unfrequently presentation and to consider combined chemohormonal therapy since the diagnosis.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Intravascular disseminated coagulopathy as a debut of metastatic prostate cancer: A case report

Olarte

Unceta

Kopp

et al. 2017

JST

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“…For example, Italian or Japanese clinical practice guidelines for DIC treatment have recommended the use of rhs-TM, while British clinical practice guidelines have not mentioned the use of rhs-TM. [23][24][25][26] In addition, developing nations tend to have lower diffusion speeds and lower maximum penetration levels of new drugs than do developed countries. 27 Therefore, further investigation of the use of rhs-TM in other countries is vital to confirm the impact of the increasing use of rhs-TM in patients with infectious disease-associated DIC.…”

Section: Discussionmentioning

confidence: 99%

Recent Change in Treatment of Disseminated Intravascular Coagulation in Japan

Murata

Okamoto

Mayumi

et al. 2015

Clin Appl Thromb Hemost

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This study investigated the time trends and hospital factors affecting the use of drugs for infectious disease-associated disseminated intravascular coagulation (DIC) based on a national administrative database. A total of 14 324 patients with infectious disease-associated DIC were referred to 1041 hospitals from 2010 to 2012 in Japan. Patients' data were collected from the administrative database to determine time trends and hospital factors affecting the use of drugs for DIC. Three study periods were established, namely, the fiscal years 2010 (n ¼ 3308), 2011 (n ¼ 5403), and 2012 (n ¼ 5613). The use of antithrombin, heparin, protease inhibitors, and recombinant human soluble thrombomodulin (rhs-TM) for DIC was evaluated. The frequency of use of antithrombin, heparin, and protease inhibitors decreased while that of rhs-TM significantly increased from 2010 to 2012 in Japan (25.1% in 2010, 43.1% in 2011, and 56.8% in 2012; P < .001, respectively). Logistic regression showed that the study period was associated with the use of rhs-TM in patients with DIC. The odds ratio (OR) for 2011 was 2.34 (95% confidence interval [CI], 2.12-2.58; P < .001) whereas that for 2012 was 4.34 (95% CI, 3.94-4.79; P < .001). A large hospital size was the most significant factor associated with the use of rhs-TM in patients with DIC (OR, 3.14; 95% CI, 2.68-3.66; P < .001). The use of rhs-TM has dramatically increased. A large hospital size was significantly associated with the increased use of rhs-TM in patients with DIC from 2010 to 2012 in Japan.

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Acquired Bleeding Disorders

O’Sullivan

Hunt

2015

Encyclopedia of Life Sciences

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Acquired bleeding disorders include disseminated intravascular coagulation ( DIC ), vitamin K deficiency, massive transfusion, renal and liver disease and hyperfibrinolysis. A history of a bleeding tendency should be followed by appropriate laboratory investigations. DIC is characterised by consumption of platelets and coagulation factors and increased fibrinolytic activity. The treatment of the underlying condition is key to DIC management. In major bleeding, serial coagulation tests should be performed to guide use of blood components. Vitamin K deficiency occurs in neonates and malabsorptive states. Abnormalities in liver disease involve coagulation and fibrinolytic defects and platelet dysfunction, whereas in renal disease, abnormal platelet function and adhesion is the primary abnormality. Hyperfibrinolysis involves excessive fibrinolytic activity causing disproportionately elevated FDPs (fibrinogen degradation products) (D‐dimer levels) and should be considered in patients with liver disease and disseminated cancers. Acquired coagulation inhibitors result from immune‐mediated inhibition of a coagulation factor in patients with inherited bleeding disorder or previously normal haemostasis. Key Concepts Key to management of DIC is treatment of the underlying condition. Only replace coagulation proteins and platelets in bleeding patient or for planned interventions. Early use of fresh frozen plasma to prevent coagulopathy development is currently recommended. Tranexamic acid should be given in all patients at risk of or with significant bleeding. Vitamin K prophylaxis should be offered to all neonates at birth. Prothrombin complex concentrate is recommended when rapid reversal of vitamin K antagonist therapy is required. Vitamin K given either orally or intravenously will reverse the effects of VKAs in 6 h. In liver disease, asymptomatic patients with abnormal coagulation tests do not routinely require replacement therapy. Abnormalities of platelet function and adhesion are the major causes of bleeding in renal disease. Acquired coagulation inhibitors can occur in patients with congenital coagulation factor deficiencies or in patients with previously normal haemostasis.

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Guidance for diagnosis and treatment of disseminated intravascular coagulation from harmonization of the recommendations from three guidelines

Cited by 398 publications

References 49 publications

Intravascular disseminated coagulopathy as a debut of metastatic prostate cancer: A case report

Intravascular disseminated coagulopathy as a debut of metastatic prostate cancer: A case report

Recent Change in Treatment of Disseminated Intravascular Coagulation in Japan

Acquired Bleeding Disorders

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