Disseminated intravascular coagulopathy in infection compared with that in malignant neoplasia.
The organic symptoms and results of coagulation tests of disseminated intravascular coagulopathy (DIC) in 17 patients with infection were compared with those in 12 patients with malignancy. The infectious diseases were mainly sepsis and pneumonia, and the malignancy was mainly lung cancer. The mean antithrombin III (AT III) before treatment was 54% in infection and 68% in malignancy, and the AT III values improved after administration of 1500 U of AT III concentrates per day. The mean thrombin-antithrombin complex level decreased from 22 ng/ml to 9 ng/ml after the treatment in infection, but it increased in malignancy. There were no differences in DIC scores between infection and malignancy before treatment; however, the scores were significantly more improved in infection than in malignancy after treatment (p < 0.05). The fibrin/fibrinogen degradation product level, platelet count, and fibronectin level were also significantly more improved in infection than in malignancy. This better response to treatment in infection than in malignancy is probably due to eradication of the causative organisms by antibiotics in infection. These data suggest that therapy against both DIC and the underlying disease is crucial for successful treatment.
Kohno
S
S
Second Department of Internal Medicine, Nagasaki University.
Inoue
Y
Y
Koga
H
H
Kaku
M
M
Kadota
J
J
Oka
M
M
Hara
K
K
D000368:Aged; D000369:Aged, 80 and over; D000990:Antithrombin III / Q000378:metabolism; D004211:Disseminated Intravascular Coagulation / Q000097:blood / Q000209:etiology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010447:Peptide Hydrolases / Q000378:metabolism; D011014:Pneumonia / Q000150:complications; D018805:Sepsis / Q000150:complications*
C046193:antithrombin III-protease complex; D000990:Antithrombin III; D010447:Peptide Hydrolases