大動脈瘤に伴った消費性凝固障害の一例

概要

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A 81-year-old man was admitted with a chief complaint of the ecchymoma after slight impact on the left upper extremity. Coagulation studies revealed moderate thrombocytopenia, decreased levels of fibrinogen, factor VIII and antithrombin III, an increase of FDPs, and prolongation of prothrombin time and activated PTT. The chest X-ray film and U.C.G. showed an aneurysm of the thoracic aorta. The surface scanning after intravenous 131I-fibrinogen demonstrated an increased accumulation of the radioactivity over the aneurysm. Extensive studies failed to disclose any malignant diseases.A diagnosis of consumption coagulopathy in association with the aneurysm was made. He was treated with intravenous heparin (20,000 units/day) with rapid improvement; platelet and fibrinogen increased, FDPs levels decreased. However, the conbination therapy with aspirin and warfarin was of little effect.The association of consumption coagulopathy with aneurysm seems to be relatively rare. The pathogenesis and treatment of this disease were discussed.
一般社団法人日本血液学会の論文