Effects of recombinant human soluble thrombomodulin treatment for disseminated intravascular coagulation at a single institution-an analysis of 62 cases caused by infectious diseases and 30 cases caused by hematological diseases

Noriaki Kawano, Akira Tasaki, Takuro Kuriyama, Yoshihiro Tahara, Shuro Yoshida, Nobuyuki Ono, Daisuke Himeji, Kiyoshi Yamashita, Yoshihiro Shibata, Toshiyuki Goto, Tomohiro Inoue, Naoko Yokota-Ikeda, Shigehiro Uezono, Akihiko Yuge, Toshihiro Nishiguchi, Tamahiro Kinjo, Yasuhiro Ogura, Kiichiro Beppu, Yuji Ueda, Mariko KinoshitaHiroshi Moritake, Kazuya Shimoda, Hidenobu Ochiai, Akira Ueda

    Research output: Contribution to journalArticle

    8 Citations (Scopus)

    Abstract

    Objective Disseminated intravascular coagulation (DIC) is a clinical condition with high mortality that is characterized by the systemic activation of coagulation pathways resulting in multiple organ failure. Although no standard treatment for DIC has been established, recent reports have indicated that recombinant human soluble thrombomodulin (rTM) is effective against DIC. Methods To elucidate the clinical characteristics and outcomes of DIC, we retrospectively analyzed 92 DIC patients who were treated with rTM at Miyazaki Prefectural Hospital over a 4-year period (62 patients had infectious diseases and 30 patients had hematological diseases). A diagnosis of DIC was made based on the diagnostic criteria of the Japanese Association for Acute Medicine (JAAM) and Japanese Ministry of Health and Welfare (JMHW) for infectious diseases and hematological diseases, respectively. In addition to treating the underlying disease, rTM was administered for six consecutive days. Results In this study, 49 of the 92 DIC patients (53.3%) experienced resolution of DIC seven days after administration (46.8% patients with infectious disease and 66.7% with hematological disease). A higher survival rate was observed after a 28-day observation period in 69 of the 92 patients (75.0%) (72.6% of the patients with infectious disease and 80.0% of the patients with hematological disease). A lower DIC score at the initiation of rTM treatment was closely related to a higher rate of resolution of DIC. Conclusion Our findings indicate that rTM therapy is an effective, safe and feasible treatment for DIC patients. Furthermore, making an accurate and early diagnosis of DIC and providing subsequent immediate treatment with rTM may improve the resolution of DIC.

    Original languageEnglish
    Pages (from-to)205-213
    Number of pages9
    JournalInternal Medicine
    Volume53
    Issue number3
    DOIs
    Publication statusPublished - Feb 7 2014

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    Hematologic Diseases
    Disseminated Intravascular Coagulation
    Communicable Diseases
    Therapeutics
    human THBD protein
    Multiple Organ Failure
    Early Diagnosis
    Survival Rate

    All Science Journal Classification (ASJC) codes

    • Internal Medicine

    Cite this

    Effects of recombinant human soluble thrombomodulin treatment for disseminated intravascular coagulation at a single institution-an analysis of 62 cases caused by infectious diseases and 30 cases caused by hematological diseases. / Kawano, Noriaki; Tasaki, Akira; Kuriyama, Takuro; Tahara, Yoshihiro; Yoshida, Shuro; Ono, Nobuyuki; Himeji, Daisuke; Yamashita, Kiyoshi; Shibata, Yoshihiro; Goto, Toshiyuki; Inoue, Tomohiro; Yokota-Ikeda, Naoko; Uezono, Shigehiro; Yuge, Akihiko; Nishiguchi, Toshihiro; Kinjo, Tamahiro; Ogura, Yasuhiro; Beppu, Kiichiro; Ueda, Yuji; Kinoshita, Mariko; Moritake, Hiroshi; Shimoda, Kazuya; Ochiai, Hidenobu; Ueda, Akira.

    In: Internal Medicine, Vol. 53, No. 3, 07.02.2014, p. 205-213.

    Research output: Contribution to journalArticle

    Kawano, N, Tasaki, A, Kuriyama, T, Tahara, Y, Yoshida, S, Ono, N, Himeji, D, Yamashita, K, Shibata, Y, Goto, T, Inoue, T, Yokota-Ikeda, N, Uezono, S, Yuge, A, Nishiguchi, T, Kinjo, T, Ogura, Y, Beppu, K, Ueda, Y, Kinoshita, M, Moritake, H, Shimoda, K, Ochiai, H & Ueda, A 2014, 'Effects of recombinant human soluble thrombomodulin treatment for disseminated intravascular coagulation at a single institution-an analysis of 62 cases caused by infectious diseases and 30 cases caused by hematological diseases', Internal Medicine, vol. 53, no. 3, pp. 205-213. https://doi.org/10.2169/internalmedicine.53.0715
    Kawano, Noriaki ; Tasaki, Akira ; Kuriyama, Takuro ; Tahara, Yoshihiro ; Yoshida, Shuro ; Ono, Nobuyuki ; Himeji, Daisuke ; Yamashita, Kiyoshi ; Shibata, Yoshihiro ; Goto, Toshiyuki ; Inoue, Tomohiro ; Yokota-Ikeda, Naoko ; Uezono, Shigehiro ; Yuge, Akihiko ; Nishiguchi, Toshihiro ; Kinjo, Tamahiro ; Ogura, Yasuhiro ; Beppu, Kiichiro ; Ueda, Yuji ; Kinoshita, Mariko ; Moritake, Hiroshi ; Shimoda, Kazuya ; Ochiai, Hidenobu ; Ueda, Akira. / Effects of recombinant human soluble thrombomodulin treatment for disseminated intravascular coagulation at a single institution-an analysis of 62 cases caused by infectious diseases and 30 cases caused by hematological diseases. In: Internal Medicine. 2014 ; Vol. 53, No. 3. pp. 205-213.
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    abstract = "Objective Disseminated intravascular coagulation (DIC) is a clinical condition with high mortality that is characterized by the systemic activation of coagulation pathways resulting in multiple organ failure. Although no standard treatment for DIC has been established, recent reports have indicated that recombinant human soluble thrombomodulin (rTM) is effective against DIC. Methods To elucidate the clinical characteristics and outcomes of DIC, we retrospectively analyzed 92 DIC patients who were treated with rTM at Miyazaki Prefectural Hospital over a 4-year period (62 patients had infectious diseases and 30 patients had hematological diseases). A diagnosis of DIC was made based on the diagnostic criteria of the Japanese Association for Acute Medicine (JAAM) and Japanese Ministry of Health and Welfare (JMHW) for infectious diseases and hematological diseases, respectively. In addition to treating the underlying disease, rTM was administered for six consecutive days. Results In this study, 49 of the 92 DIC patients (53.3{\%}) experienced resolution of DIC seven days after administration (46.8{\%} patients with infectious disease and 66.7{\%} with hematological disease). A higher survival rate was observed after a 28-day observation period in 69 of the 92 patients (75.0{\%}) (72.6{\%} of the patients with infectious disease and 80.0{\%} of the patients with hematological disease). A lower DIC score at the initiation of rTM treatment was closely related to a higher rate of resolution of DIC. Conclusion Our findings indicate that rTM therapy is an effective, safe and feasible treatment for DIC patients. Furthermore, making an accurate and early diagnosis of DIC and providing subsequent immediate treatment with rTM may improve the resolution of DIC.",
    author = "Noriaki Kawano and Akira Tasaki and Takuro Kuriyama and Yoshihiro Tahara and Shuro Yoshida and Nobuyuki Ono and Daisuke Himeji and Kiyoshi Yamashita and Yoshihiro Shibata and Toshiyuki Goto and Tomohiro Inoue and Naoko Yokota-Ikeda and Shigehiro Uezono and Akihiko Yuge and Toshihiro Nishiguchi and Tamahiro Kinjo and Yasuhiro Ogura and Kiichiro Beppu and Yuji Ueda and Mariko Kinoshita and Hiroshi Moritake and Kazuya Shimoda and Hidenobu Ochiai and Akira Ueda",
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    T1 - Effects of recombinant human soluble thrombomodulin treatment for disseminated intravascular coagulation at a single institution-an analysis of 62 cases caused by infectious diseases and 30 cases caused by hematological diseases

    AU - Kawano, Noriaki

    AU - Tasaki, Akira

    AU - Kuriyama, Takuro

    AU - Tahara, Yoshihiro

    AU - Yoshida, Shuro

    AU - Ono, Nobuyuki

    AU - Himeji, Daisuke

    AU - Yamashita, Kiyoshi

    AU - Shibata, Yoshihiro

    AU - Goto, Toshiyuki

    AU - Inoue, Tomohiro

    AU - Yokota-Ikeda, Naoko

    AU - Uezono, Shigehiro

    AU - Yuge, Akihiko

    AU - Nishiguchi, Toshihiro

    AU - Kinjo, Tamahiro

    AU - Ogura, Yasuhiro

    AU - Beppu, Kiichiro

    AU - Ueda, Yuji

    AU - Kinoshita, Mariko

    AU - Moritake, Hiroshi

    AU - Shimoda, Kazuya

    AU - Ochiai, Hidenobu

    AU - Ueda, Akira

    PY - 2014/2/7

    Y1 - 2014/2/7

    N2 - Objective Disseminated intravascular coagulation (DIC) is a clinical condition with high mortality that is characterized by the systemic activation of coagulation pathways resulting in multiple organ failure. Although no standard treatment for DIC has been established, recent reports have indicated that recombinant human soluble thrombomodulin (rTM) is effective against DIC. Methods To elucidate the clinical characteristics and outcomes of DIC, we retrospectively analyzed 92 DIC patients who were treated with rTM at Miyazaki Prefectural Hospital over a 4-year period (62 patients had infectious diseases and 30 patients had hematological diseases). A diagnosis of DIC was made based on the diagnostic criteria of the Japanese Association for Acute Medicine (JAAM) and Japanese Ministry of Health and Welfare (JMHW) for infectious diseases and hematological diseases, respectively. In addition to treating the underlying disease, rTM was administered for six consecutive days. Results In this study, 49 of the 92 DIC patients (53.3%) experienced resolution of DIC seven days after administration (46.8% patients with infectious disease and 66.7% with hematological disease). A higher survival rate was observed after a 28-day observation period in 69 of the 92 patients (75.0%) (72.6% of the patients with infectious disease and 80.0% of the patients with hematological disease). A lower DIC score at the initiation of rTM treatment was closely related to a higher rate of resolution of DIC. Conclusion Our findings indicate that rTM therapy is an effective, safe and feasible treatment for DIC patients. Furthermore, making an accurate and early diagnosis of DIC and providing subsequent immediate treatment with rTM may improve the resolution of DIC.

    AB - Objective Disseminated intravascular coagulation (DIC) is a clinical condition with high mortality that is characterized by the systemic activation of coagulation pathways resulting in multiple organ failure. Although no standard treatment for DIC has been established, recent reports have indicated that recombinant human soluble thrombomodulin (rTM) is effective against DIC. Methods To elucidate the clinical characteristics and outcomes of DIC, we retrospectively analyzed 92 DIC patients who were treated with rTM at Miyazaki Prefectural Hospital over a 4-year period (62 patients had infectious diseases and 30 patients had hematological diseases). A diagnosis of DIC was made based on the diagnostic criteria of the Japanese Association for Acute Medicine (JAAM) and Japanese Ministry of Health and Welfare (JMHW) for infectious diseases and hematological diseases, respectively. In addition to treating the underlying disease, rTM was administered for six consecutive days. Results In this study, 49 of the 92 DIC patients (53.3%) experienced resolution of DIC seven days after administration (46.8% patients with infectious disease and 66.7% with hematological disease). A higher survival rate was observed after a 28-day observation period in 69 of the 92 patients (75.0%) (72.6% of the patients with infectious disease and 80.0% of the patients with hematological disease). A lower DIC score at the initiation of rTM treatment was closely related to a higher rate of resolution of DIC. Conclusion Our findings indicate that rTM therapy is an effective, safe and feasible treatment for DIC patients. Furthermore, making an accurate and early diagnosis of DIC and providing subsequent immediate treatment with rTM may improve the resolution of DIC.

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