chondroitin-sulfates and Hemangioma

A 32-year-old woman was admitted with intermittent rectal bleeding with disseminated intravascular coagulation (DIC)-like coagulopathy. CT and MRI revealed a retroperitoneal tumor, and we diagnosed giant retroperitoneal hemangioma complicated with Kasabach-Merritt syndrome, following blood pool scintigraphy. Corticosteroid and interferon-alpha were not effective, and gabexate mesilate was also ineffective for coagulopathy. Immediately after receiving danaparoid sodium, she recovered from DIC. We performed tumor resection successfully, and she had no symptoms of coagulopathy thereafter.

Topics: Adult; Anticoagulants; Chondroitin Sulfates; Dermatan Sulfate; Disseminated Intravascular Coagulation; Female; Hemangioma; Heparitin Sulfate; Humans; Retroperitoneal Neoplasms

n patients with Kasabach-Merritt syndrome (KMS), local activation of coagulation commonly results in disseminated intravascular coagulation (DIC). Progress of DIC is associated with 30-40% mortality as a result of uncontrollable hemorrhage. A 39-year-old woman with an enlarging giant liver hemangioma was diagnosed as having KMS with DIC. To control the hemorrhagic diathesis, we commenced combination therapy for DIC with danaparoid (1,250 Ux2/day, intravenously (IV)) and tranexamic acid (0.5 g x 3/day, peros (PO). Rapid improvement of the bleeding tendency and coagulopathy occurred in response to this treatment - that is, DIC was controlled without removing the giant hemangioma. The therapy did not restrict the behavior of the patient by continuous drip and angiography could be performed without bleeding. Such therapy may be beneficial in chronic DIC with activation of fibrinolysis.

Topics: Adult; Antifibrinolytic Agents; Blood Proteins; Chondroitin Sulfates; Dermatan Sulfate; Disseminated Intravascular Coagulation; Drug Therapy, Combination; Female; Hemangioma; Hemorrhagic Disorders; Heparitin Sulfate; Hepatic Artery; Humans; Ligation; Liver Neoplasms; Syndrome; Tranexamic Acid