Clinical features and outcomes of 35 disseminated intravascular coagulation cases treated with recombinant human soluble thrombomodulin at a single institution.

Noriaki Kawano, Shuro Yoshida, Nobuyuki Ono, Daisuke Himeji, Yuri Nagahiro, Kawano Sayaka Kawano, Kiyoshi Yamashita, Naoko Ikeda, Shigehiro Uezono, Hidenobu Ochiai, Fumiko Kawano, Ikuo Kikuchi, Fumihiko Ishikawa, Kazuya Shimoda, Akira Ueda, Koichi Akashi

Research output: Contribution to journalArticle

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Abstract

Disseminated intravascular coagulation (DIC) is a clinical entity with high mortality and is characterized by multiple organ failure caused by activation of systemic intravascular coagulation. Although a standard treatment for DIC has not been established owing to the absence of randomized controlled trials, recent reports have indicated that recombinant human soluble thrombomodulin (rTM) is effective against DIC. To elucidate the clinical characteristics and outcomes of DIC, we retrospectively analyzed 35 DIC patients treated with rTM at our institution over a 2-year period (infectious disease: 21 cases; hematological disease: 14 cases). Diagnosis of DIC was based on the diagnostic criteria for DIC of the Japanese Ministry of Health and Welfare. In addition to the treatment of underlying diseases, we administered rTM for 6 consecutive days. Twenty-one (60.0%) of the DIC patients attained resolution of DIC at 7 days after administration (infectious disease: 61.9%; hematological disease: 57.1%). Furthermore, 7 of the remaining 14 DIC patients (who did not attain resolution at 7 days) attained resolution at an average of 12.1 days. Consequently, 28 (80.0%) of the 35 patients were alive with resolution of DIC after a 28-day observation period (infectious disease: 76.2%; hematological disease: 85.7%). Among them, for 7 (70%) of the 10 DIC patients with severe life-threatening bleeding symptoms without hemorrhagic shock, treatment with heparin was contraindicated; these patients were successfully treated with rTM without the progression of hemorrhage. In the majority of DIC patients, rTM administration may be an effective, safe, and feasible therapeutic modality producing a good outcome.

Original languageEnglish
Pages (from-to)101-107
Number of pages7
JournalJournal of clinical and experimental hematopathology : JCEH
Volume51
Issue number2
DOIs
Publication statusPublished - 2011

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Disseminated Intravascular Coagulation
Hematologic Diseases
Communicable Diseases
human THBD protein
Hemorrhage
Multiple Organ Failure
Hemorrhagic Shock
Therapeutics
Heparin
Randomized Controlled Trials

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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Clinical features and outcomes of 35 disseminated intravascular coagulation cases treated with recombinant human soluble thrombomodulin at a single institution. / Kawano, Noriaki; Yoshida, Shuro; Ono, Nobuyuki; Himeji, Daisuke; Nagahiro, Yuri; Sayaka Kawano, Kawano; Yamashita, Kiyoshi; Ikeda, Naoko; Uezono, Shigehiro; Ochiai, Hidenobu; Kawano, Fumiko; Kikuchi, Ikuo; Ishikawa, Fumihiko; Shimoda, Kazuya; Ueda, Akira; Akashi, Koichi.

In: Journal of clinical and experimental hematopathology : JCEH, Vol. 51, No. 2, 2011, p. 101-107.

Research output: Contribution to journalArticle

Kawano, N, Yoshida, S, Ono, N, Himeji, D, Nagahiro, Y, Sayaka Kawano, K, Yamashita, K, Ikeda, N, Uezono, S, Ochiai, H, Kawano, F, Kikuchi, I, Ishikawa, F, Shimoda, K, Ueda, A & Akashi, K 2011, 'Clinical features and outcomes of 35 disseminated intravascular coagulation cases treated with recombinant human soluble thrombomodulin at a single institution.', Journal of clinical and experimental hematopathology : JCEH, vol. 51, no. 2, pp. 101-107. https://doi.org/10.3960/jslrt.51.101
Kawano, Noriaki ; Yoshida, Shuro ; Ono, Nobuyuki ; Himeji, Daisuke ; Nagahiro, Yuri ; Sayaka Kawano, Kawano ; Yamashita, Kiyoshi ; Ikeda, Naoko ; Uezono, Shigehiro ; Ochiai, Hidenobu ; Kawano, Fumiko ; Kikuchi, Ikuo ; Ishikawa, Fumihiko ; Shimoda, Kazuya ; Ueda, Akira ; Akashi, Koichi. / Clinical features and outcomes of 35 disseminated intravascular coagulation cases treated with recombinant human soluble thrombomodulin at a single institution. In: Journal of clinical and experimental hematopathology : JCEH. 2011 ; Vol. 51, No. 2. pp. 101-107.
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abstract = "Disseminated intravascular coagulation (DIC) is a clinical entity with high mortality and is characterized by multiple organ failure caused by activation of systemic intravascular coagulation. Although a standard treatment for DIC has not been established owing to the absence of randomized controlled trials, recent reports have indicated that recombinant human soluble thrombomodulin (rTM) is effective against DIC. To elucidate the clinical characteristics and outcomes of DIC, we retrospectively analyzed 35 DIC patients treated with rTM at our institution over a 2-year period (infectious disease: 21 cases; hematological disease: 14 cases). Diagnosis of DIC was based on the diagnostic criteria for DIC of the Japanese Ministry of Health and Welfare. In addition to the treatment of underlying diseases, we administered rTM for 6 consecutive days. Twenty-one (60.0{\%}) of the DIC patients attained resolution of DIC at 7 days after administration (infectious disease: 61.9{\%}; hematological disease: 57.1{\%}). Furthermore, 7 of the remaining 14 DIC patients (who did not attain resolution at 7 days) attained resolution at an average of 12.1 days. Consequently, 28 (80.0{\%}) of the 35 patients were alive with resolution of DIC after a 28-day observation period (infectious disease: 76.2{\%}; hematological disease: 85.7{\%}). Among them, for 7 (70{\%}) of the 10 DIC patients with severe life-threatening bleeding symptoms without hemorrhagic shock, treatment with heparin was contraindicated; these patients were successfully treated with rTM without the progression of hemorrhage. In the majority of DIC patients, rTM administration may be an effective, safe, and feasible therapeutic modality producing a good outcome.",
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AU - Kawano, Noriaki

AU - Yoshida, Shuro

AU - Ono, Nobuyuki

AU - Himeji, Daisuke

AU - Nagahiro, Yuri

AU - Sayaka Kawano, Kawano

AU - Yamashita, Kiyoshi

AU - Ikeda, Naoko

AU - Uezono, Shigehiro

AU - Ochiai, Hidenobu

AU - Kawano, Fumiko

AU - Kikuchi, Ikuo

AU - Ishikawa, Fumihiko

AU - Shimoda, Kazuya

AU - Ueda, Akira

AU - Akashi, Koichi

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