Effective Control of Relapsing Disseminated Intravascular Coagulation in a Patient with Decompensated Liver Cirrhosis by Recombinant Soluble Thrombomodulin

Takumu Hasebe; Koji Sawada; Shunsuke Nakajima; Shigeaki Maeda; Masami Abe; Yasuaki Suzuki; Takaaki Ohtake; Chitomi Hasebe; Mikihiro Fujiya; Yutaka Kohgo

doi:10.2169/internalmedicine.53.1201

CASE REPORTS

Effective Control of Relapsing Disseminated Intravascular Coagulation in a Patient with Decompensated Liver Cirrhosis by Recombinant Soluble Thrombomodulin

Takumu Hasebe, Koji Sawada, Shunsuke Nakajima, Shigeaki Maeda, Masami Abe, Yasuaki Suzuki, Takaaki Ohtake, Chitomi Hasebe, Mikihiro Fujiya, Yutaka Kohgo

Author information

Takumu Hasebe
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Japan
Koji Sawada
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Japan
Shunsuke Nakajima
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Japan
Shigeaki Maeda
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Japan
Masami Abe
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Japan
Yasuaki Suzuki
Department of Gastroenterology, Nayoro City General Hospital, Japan
Takaaki Ohtake
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Japan
Chitomi Hasebe
Department of Gasroentelorogy, Asahikawa Red Cross Hospital, Japan
Mikihiro Fujiya
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Japan
Yutaka Kohgo
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Japan

Keywords: recombinant human soluble thrombomodulin, chronic disseminated intravascular coagulation, liver cirrhosis

JOURNAL OPEN ACCESS

2014 Volume 53 Issue 1 Pages 29-33

DOI https://doi.org/10.2169/internalmedicine.53.1201

Details

Abstract

A 70-year-old Japanese man was hospitalized for expanding purpura and chronic disseminated intravascular coagulation (DIC) caused by decompensated liver cirrhosis. As there are no effective treatments for chronic DIC caused by liver cirrhosis, we decided to administer recombinant human soluble thrombomodulin (rhsTM) after he provided informed consent. The DIC was rapidly improved; however, the purpura and coagulopathy recurred after two months, and repeated rhsTM treatments were required. The rhsTM treatment sufficiently controlled the coagulopathy for two years, without any complications, including bleeding. This is the first report demonstrating that rhsTM can be administered safely and repeatedly to a patient with decompensated liver cirrhosis, and that it appears to be associated with a favorable outcome.

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