scholarly journals Prostate Cancer-Associated Disseminated Intravascular Coagulation with Excessive Fibrinolysis Treated with Degarelix

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Shawn Y. Ong ◽  
Josephine Taverna ◽  
Clint Jokerst ◽  
Thomas Enzler ◽  
Emad Hammode ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Disseminated Intravascular Coagulation ◽  
Single Injection ◽  
Gonadotropin Releasing Hormone ◽  
Therapeutic Drug ◽  
Hemorrhagic Complication ◽  
Intravascular Coagulation ◽  
Life Threatening ◽  
Fast Acting

Disseminated intravascular coagulation (DIC) with excessive fibrinolysis (XFL) is a rare and acute life-threatening variant of DIC in patients with prostate cancer. Patients present with coagulopathy, hypofibrinogenemia, and systemic bleeding. We describe a case of DIC XFL caused by prostate cancer (PC) successfully treated with a single injection of degarelix, a gonadotropin-releasing hormone (GnRH) receptor antagonist. This led to prompt control of the patient’s coagulopathy within ten days of treatment. Our case highlights features of this rare and devastating hemorrhagic complication of PC along with a fast-acting and effective therapeutic drug option.

scholarly journals Extracellular Vesicle-Associated Tissue Factor Activity in Prostate Cancer Patients with Disseminated Intravascular Coagulation

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1487
Author(s):  
Lena Hell ◽  
Thomas Däullary ◽  
Vanessa Burghart ◽  
Lisa-Marie Mauracher ◽  
Ella Grilz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Tissue Factor ◽  
Disseminated Intravascular Coagulation ◽  
Mononuclear Cells ◽  
Coagulation Cascade ◽  
Dependent Manner ◽  
Peripheral Blood Mononuclear ◽  
Intravascular Coagulation

Patients with advanced prostate cancer may develop fulminant disseminated intravascular coagulation (DIC). Circulating extracellular vesicles (EVs)-exposing tissue factor (TF), the initiator of the coagulation cascade, may play an important role. We included 7 prostate cancer patients with DIC, 10 age- and stage-matched cancer controls without DIC, and 10 age-matched healthy male individuals. EV-TF activity was highly elevated in prostate cancer patients with DIC (11.40 pg/mL; range: 4.34–27.06) compared with prostate cancer patients without DIC (0.09 pg/mL; range: 0.00–0.30, p = 0.001) and healthy controls (0.18 pg/mL; range: 0.09–0.54; p = 0.001). Only EVs from patients with DIC showed reduced fibrin clot formation time of pooled plasma in a TF-dependent manner. Next, we performed in vitro co-culture experiments including EVs derived from a prostate cancer cell line with high (DU145) and low (LNCaP) TF expression, peripheral blood mononuclear cells (PBMCs), and platelets. Co-incubation of DU145 EVs with PBMCs and platelets significantly increased EV-TF activity in conditioned medium and induced TF activity on monocytes. No such effects were seen in co-culture experiments with LNCaP EVs. In conclusion, the findings indicate that elevated EV-TF activity plays a role in the development of prostate-cancer-related DIC and may result from interactions between tumor-derived EVs, monocytes, and platelets.

scholarly journals ALK-Negative Anaplastic Large Cell Lymphoma Presenting as Disseminated Intravascular Coagulation and Hemophagocytic Lymphohistiocytosis: A Potentially Fatal Presentation

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Uroosa Ibrahim ◽  
Amina Saqib ◽  
Maryam Rehan ◽  
Jean Paul Atallah
Keyword(s):  
Disseminated Intravascular Coagulation ◽  
Anaplastic Large Cell Lymphoma ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Cell Lymphoma ◽  
Large Cell ◽  
Lymph Node Biopsy ◽  
Intravascular Coagulation ◽  
Primary Disorder ◽  
Life Threatening ◽  
Large Cell Lymphoma

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disorder that can be familial in etiology or a result of infections, malignancy, and autoimmune or inflammatory disorders. Disseminated intravascular coagulation (DIC) is common in patients admitted to intensive care units and can confound and delay the diagnosis of HLH. We present a case of a 69-year-old female who presented with dyspnea and malaise. Her condition declined rapidly with laboratory parameters consistent with DIC. In addition, she had a ferritin of 32,522 ng/mL, low haptoglobin, and elevated LDH, and bone marrow biopsy showed hemophagocytic lymphohistiocytes. She was started on HLH-directed therapy, and later, a diagnosis of ALK-negative anaplastic large cell lymphoma was made on an excisional inguinal lymph node biopsy specimen. Our case emphasizes the importance of prompt recognition, diagnosis, and treatment of HLH while workup for a primary disorder is still being pursued.

Acute Disseminated Intravascular Coagulation After Prophylactic Nailing of the Femur in a Patient with Metastatic Prostate Cancer

2020 ◽  
Vol 10 (1) ◽  
pp. e0370-e0370
Author(s):  
Daniel Z. You ◽  
Joseph K. Kendal ◽  
Paul Duffy ◽  
Michael J. Monument ◽  
Prism S. Schneider
Keyword(s):  
Prostate Cancer ◽  
Disseminated Intravascular Coagulation ◽  
Metastatic Prostate Cancer ◽  
Intravascular Coagulation

scholarly journals Disseminated Intravascular Coagulation as an Initial Manifestation of Metastatic Prostate Cancer Emergently Treated with Docetaxel-Based Chemotherapy

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Kavita Agrawal ◽  
Nirav Agrawal ◽  
Levin Miles
Keyword(s):  
Prostate Cancer ◽  
Weight Loss ◽  
Disseminated Intravascular Coagulation ◽  
Metastatic Prostate Cancer ◽  
Degradation Products ◽  
Specific Antigen ◽  
Mass Effect ◽  
Whole Body ◽  
Initial Manifestation ◽  
Intravascular Coagulation

A 70-year-old male presented with hematuria and bruising of arms and legs for the last three days. He also complained of urinary frequency and hesitancy and weight loss of 40 pounds over a span of four months. Initial blood tests showed prothrombin time (PT) of 25.1 seconds, international normalized ratio (INR) of 2.5, partial thromboplastin time (PTT) of 43.9 seconds, fibrinogen of 60 mg/dl, fibrin degradation products (FDP) of more than 20 μg/ml, and platelets of 88,000/μl. The impression was disseminated intravascular coagulation (DIC). A search was initiated to determine the underlying etiology precipitating DIC. Due to urinary symptoms and weight loss, prostate-specific antigen (PSA) was ordered. PSA was elevated at 942 μg/dl. Computed tomography (CT) of the abdomen and pelvis without contrast showed an enlarged prostate with mass effect on the bladder base, left-sided hydronephrosis, and numerous enlarged pelvic lymph nodes. A bone scan of the whole body showed increased sclerosis of the L3 vertebral body. There was a concern for metastatic prostate cancer precipitating DIC. On first admission, our patient’s DIC was stabilized with FFP and cryoprecipitate transfusions. He refused chemotherapy, and degarelix was not economically feasible. Accordingly, he was started on androgen deprivation therapy (ADT), bicalutamide, and leuprolide as an inpatient, pending the tissue biopsy. The patient refused a prostate biopsy. A bone marrow biopsy was performed which confirmed metastatic prostate adenocarcinoma. The patient was stable for discharge with a plan for outpatient chemotherapy. Subsequently, he was lost to follow-up with the oncology. Six months after the initial presentation, he was readmitted with hematuria. Repeat PSA worsened to 1,970 μg/dl. Blood work was consistent with acute DIC. He refused chemotherapy again. So, he was restarted on ADT. However, his hematuria and DIC panel were worsening. He was emergently started on docetaxel as an inpatient (after patient agreement). Within three days of starting chemotherapy, his hematuria resolved and DIC panel showed consistent improvement.

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