Kasabach-Merritt syndrome associated with giant liver hemangioma: the effect of combined therapy with danaparoid sodium and tranexamic acid.
n patients with Kasabach-Merritt syndrome (KMS), local activation of coagulation commonly results in disseminated intravascular coagulation (DIC). Progress of DIC is associated with 30-40% mortality as a result of uncontrollable hemorrhage. A 39-year-old woman with an enlarging giant liver hemangioma was diagnosed as having KMS with DIC. To control the hemorrhagic diathesis, we commenced combination therapy for DIC with danaparoid (1,250 Ux2/day, intravenously (IV)) and tranexamic acid (0.5 g x 3/day, peros (PO). Rapid improvement of the bleeding tendency and coagulopathy occurred in response to this treatment - that is, DIC was controlled without removing the giant hemangioma. The therapy did not restrict the behavior of the patient by continuous drip and angiography could be performed without bleeding. Such therapy may be beneficial in chronic DIC with activation of fibrinolysis.
Ontachi
Yasuo
Y
Department of Internal Medicine (III), Kanazawa University School of Medicine, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641, JAPAN. ontachiy@med3.m.kanazawa-u.ac.jp
Asakura
Hidesaku
H
Omote
Mika
M
Yoshida
Tomotaka
T
Matsui
Osamu
O
Nakao
Shinji
S
D000328:Adult; D000933:Antifibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001798:Blood Proteins / Q000032:analysis; D002809:Chondroitin Sulfates / Q000008:administration & dosage / Q000627:therapeutic use*; D003871:Dermatan Sulfate / Q000008:administration & dosage / Q000627:therapeutic use*; D004211:Disseminated Intravascular Coagulation / Q000188:drug therapy / Q000209:etiology*; D004359:Drug Therapy, Combination; D005260:Female; D006391:Hemangioma / Q000097:blood / Q000150:complications* / Q000601:surgery; D006474:Hemorrhagic Disorders / Q000188:drug therapy / Q000209:etiology*; D006497:Heparan Sulfate / Q000008:administration & dosage / Q000627:therapeutic use*; D006499:Hepatic Artery / Q000601:surgery; D006801:Humans; D008026:Ligation; D008113:Liver Neoplasms / Q000097:blood / Q000150:complications* / Q000601:surgery; D013577:Syndrome; D014148:Tranexamic Acid / Q000008:administration & dosage / Q000627:therapeutic use*
D000933:Antifibrinolytic Agents; D001798:Blood Proteins; D002809:Chondroitin Sulfates; D003871:Dermatan Sulfate; D006497:Heparan Sulfate; D014148:Tranexamic Acid; C035838:danaparoid