Disseminated intravascular coagulation in a patient treated with strontium-89 for metastatic carcinoma of the prostate.
Strontium-89 is effective in the palliation of bone pain caused by skeletal metastases. Its primary side effect is mild thrombocytopenia that typically recovers in 3 or 4 months. Subclinical disseminated intravascular coagulation is reported to be present in approximately 10% to 20% of patients with advanced prostate cancer. These patients may be at increased risk for severe marrow depression after radionuclide therapy for bone pain palliation. This report describes a patient with painful bony metastases resulting from prostate carcinoma. He had a normal platelet count and no clinical evidence of a coagulation disorder at the time of strontium-89 therapy, and a severe disseminated intravascular coagulation developed and lead to death after treatment. A normal platelet count before strontium-89 therapy does not preclude subsequent disseminated intravascular coagulation, and we support the Society of Nuclear Medicine's bone pain treatment procedure guideline that patients referred for bone palliation should be screened for disseminated intravascular coagulation before therapy.
Paszkowski
A L
AL
Department of Radiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Hewitt
D J
DJ
Taylor
A
A
D000230:Adenocarcinoma / Q000532:radiotherapy* / Q000556:secondary*; D000368:Aged; D001859:Bone Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D004211:Disseminated Intravascular Coagulation / Q000209:etiology*; D006801:Humans; D008297:Male; D010148:Intractable Pain / Q000532:radiotherapy; D010166:Palliative Care; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D013326:Strontium Radioisotopes / Q000009:adverse effects* / Q000627:therapeutic use
D013326:Strontium Radioisotopes