title: Effective control of relapsing disseminated intravascular coagulation in a patient with decompensated liver cirrhosis by recombinant soluble thrombomodulin.
abstract: A 70-year-old Japanese man was hospitalized for expanding purpura and chronic disseminated intravascular coagulation (DIC) caused by decompensated liver cirrhosis. As there are no effective treatments for chronic DIC caused by liver cirrhosis, we decided to administer recombinant human soluble thrombomodulin (rhsTM) after he provided informed consent. The DIC was rapidly improved; however, the purpura and coagulopathy recurred after two months, and repeated rhsTM treatments were required. The rhsTM treatment sufficiently controlled the coagulopathy for two years, without any complications, including bleeding. This is the first report demonstrating that rhsTM can be administered safely and repeatedly to a patient with decompensated liver cirrhosis, and that it appears to be associated with a favorable outcome.
authors.affiliation: Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Japan.
authors.forename: Takumu
authors.initials: T
authors.lastname: Hasebe
authors.forename: Koji
authors.initials: K
authors.lastname: Sawada
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Nakajima
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Maeda
authors.forename: Masami
authors.initials: M
authors.lastname: Abe
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Takaaki
authors.initials: T
authors.lastname: Ohtake
authors.forename: Chitomi
authors.initials: C
authors.lastname: Hasebe
authors.forename: Mikihiro
authors.initials: M
authors.lastname: Fujiya
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kohgo
mesh_terms: D000368:Aged; D004211:Disseminated Intravascular Coagulation / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D011994:Recombinant Proteins / Q000627:therapeutic use; D018180:Thrombomodulin / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D011994:Recombinant Proteins; C546931:THBD protein, human; D018180:Thrombomodulin