title: Prostate cancer: beware of disseminated intravascular coagulation.
abstract: Disseminated intravascular coagulation (DIC) is a pathological systemic condition resulting from aberrant activation of the coagulation system. It is characterised by the release and activation of procoagulants into the blood, with an associated consumption coagulopathy. Its association with solid and haematological malignancies is well described in literature. This case describes an elderly man, known to have prostate cancer, who following transurethral resection of the prostate developed DIC with haematuria, spontaneous ecchymoses and mucosal bleeding. Subsequent investigations revealed a prostate-specific antigen (PSA) >1000 µg/L, and staging CT showed multiple sclerotic metastatic lesions affecting the thoracic and lumbar vertebra, as well as infiltration into his left femur. Coagulation normalised with blood products and vitamin K within 1 week, and the patient responded to antiandrogen therapy with a reduction in pain and PSA on discharge.
authors.affiliation: Department of Medicine, Canterbury Hospital, Canterury, Kent, UK.
authors.forename: Mihir
authors.initials: M
authors.lastname: Desai
authors.affiliation: Department of Urology, Canterbury Hospital, Canterbury, Kent, UK.
authors.forename: Babbin
authors.initials: B
authors.lastname: John
authors.affiliation: Department of Haematology, Canterbury Hospital, Canterbury, Kent, UK.
authors.forename: Gillian
authors.initials: G
authors.lastname: Evans
authors.affiliation: Department of Urology, Canterbury Hospital, Canterbury, Kent, UK.
authors.forename: Ben
authors.initials: B
authors.lastname: Eddy
mesh_terms: D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000008:administration & dosage*; D000933:Antifibrinolytic Agents / Q000008:administration & dosage*; D014408:Biomarkers, Tumor / Q000097:blood; D003937:Diagnosis, Differential; D004211:Disseminated Intravascular Coagulation / Q000209:etiology* / Q000517:prevention & control*; D006417:Hematuria / Q000209:etiology; D006801:Humans; D008297:Male; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000150:complications* / Q000473:pathology; D013125:Spinal Neoplasms / Q000556:secondary*; D016896:Treatment Outcome; D014812:Vitamin K / Q000008:administration & dosage*
chemical_list: D000726:Androgen Antagonists; D000933:Antifibrinolytic Agents; D014408:Biomarkers, Tumor; D014812:Vitamin K; D017430:Prostate-Specific Antigen
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