Abstract
A 48-year-old man was admitted on Oct. 29, 1977, because of anemia and hemorrhagic tendency. Fourteen months before admission, he had epigastric pain, and 5 months later, upper GI series and gastrofiberscopic examination showed gastric cancer (Borrmann III) on the lesser curvature of the antrum. On June 8, 1977, partial gastrectomy was performed. The histology of the lesion was anaplastic adenocarcinoma. After surgery, he was treated with anti-cancer drugs for about a month. A month before admission, examination showed anemia, reticulocytosis and hemorrhagic tendency.
On admission, hematuria, thrombocytopenia, prolonged prothrombin time, delayed erythrocyte sedimentation, hypofibrinogenemia, hyperbilirubinemia, elevated FDP, elevated LDH and abnormal renal function were evident. The diagnosis of disseminated intravascular coagulation (DIC) with microangiopathic hemolytic anemia (MHA) was made and he was treated with heparin and prednisolone but he was expired on Dec. 18, 1977.
Postmortem examination revealed fibrin thrombi in the kidneys and hemorrhagic diathesis but neither primary cancer nor metastatic lesion was found.
It was suspected that anti-cancer drug therapy on the hypercoagulable state after surgery elicited DIC with MHA.
