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[Disseminated intravascular coagulation associated with vascular abnormalities].
Shinya Yamada1, Hidesaku Asakura1
1Department of Hematology, Kanazawa University Hospital.
[Rinsho Ketsueki] the Japanese Journal of Clinical Hematology
|September 3, 2025
Summary
Disseminated intravascular coagulation (DIC) linked to vascular abnormalities requires specific diagnosis using coagulation and fibrinolysis markers. Treatment focuses on the underlying cause, anticoagulation, or combined therapies, guided by patient condition and continuous testing.
Area of Science:
- Hematology
- Vascular Medicine
- Critical Care Medicine
Background:
- Disseminated intravascular coagulation (DIC) frequently complicates vascular abnormalities, including aortic aneurysms, dissections, vasculitis, and malformations.
- DIC associated with vascular abnormalities often presents with enhanced fibrinolysis, necessitating specialized diagnostic and therapeutic approaches.
Purpose of the Study:
- To outline diagnostic findings and treatment strategies for DIC in the context of vascular abnormalities.
- To provide guidance based on the "Clinical practice guidelines for management of disseminated intravascular coagulation (DIC) in Japan 2024".
Main Methods:
- Review of diagnostic markers for coagulation activation (e.g., thrombin-antithrombin complexes) and fibrinolysis activation (e.g., plasmin-α2 plasmin inhibitor complex).
- Analysis of treatment options including addressing underlying diseases, anticoagulant therapy, combined anticoagulant and antifibrinolytic therapy, and Factor XIII concentrate use.
Main Results:
- Diagnostic criteria emphasize specific coagulation and fibrinolysis activation markers.
- Treatment strategies are tailored based on bleeding symptoms, test results, underlying conditions, and patient status, with options ranging from observation to aggressive combination therapies.
Conclusions:
- Effective management of DIC with vascular abnormalities hinges on accurate diagnosis using activation markers and individualized treatment plans.
- Continuous monitoring, expert collaboration, and a robust testing system are essential for optimizing patient outcomes.
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