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Successful treatment of sepsis-induced disseminated intravascular coagulation in a patient with idiopathic thrombocytopenic purpura using recombinant human soluble thrombomodulin


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Title: Successful treatment of sepsis-induced disseminated intravascular coagulation in a patient with idiopathic thrombocytopenic purpura using recombinant human soluble thrombomodulin
Authors: Koga, Tomohiro / Inoue, Daisuke / Okada, Akitomo / Aramaki, Toshiyuki / Yamasaki, Satoshi / Nakashima, Munetoshi / Kawakami, Atsushi / Eguchi, Katsumi
Issue Date: Dec-2011
Publisher: Springer Verlag
Citation: Rheumatology International, 31(12), pp.1657-1659
Abstract: Disseminated intravascular coagulation (DIC) may complicate a variety of disorders that contribute to mortality, particularly those related to bleeding. It is therefore very difficult to manage DIC in patients with known bleeding disorders. We treated a 62-year-old woman with idiopathic thrombocytopenic purpura (ITP) complicated with sepsis-induced DIC. She had been diagnosed with ITP 8 months prior to admission. Laboratory tests showed an elevation of d-dimer and endotoxin, while pyelonephritis was shown by abdominal computed tomography. Escherichia coli was detected by blood culture. Based on these findings, the patient was diagnosed with sepsis-induced DIC due to urinary tract infection. Thrombocytopenia was refractory despite the use of antibiotics and platelet transfusion, but it was promptly improved in response to recombinant human soluble thrombomodulin (rTM). We suggest that rTM provides a new therapeutic strategy for DIC patients with high hemorrhagic risk.
Keywords: Disseminated intravascular coagulation / Idiopathic thrombocytopenic purpura / Recombinant human soluble thrombomodulin / Sepsis
URI: http://hdl.handle.net/10069/27963
ISSN: 01728172
DOI: 10.1007/s00296-010-1754-1
Rights: © Springer-Verlag 2011 / The original publication is available at www.springerlink.com
Type: Journal Article
Text Version: author
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/27963

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