Disseminated intravascular coagulation in urological malignancy

Aydin Pooli, Dharam Kaushik

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Disseminated intravascular coagulopathy (DIC) can impose a significant burden of morbidity to the patients with urologic malignancies. Although there are reports of DIC in different urologic malignancies, it is most commonly seen in prostate cancer (PCa) with an incidence of approximately 13% to 30%. However, only 0.4 to 1.6% of patients with PCa may present with clinical signs and symptoms of DIC. The incidence of DIC is shown to increase with higher Gleason score, stage and presence of metastatic disease. The underlying pathophysiology of DIC in PCa is related to the presence of pro-coagulants capable of directly activating factor X, tissue factor expression by malignant cells, secretion of pro-aggregation factors, pro-inflammatory cytokines and direct interaction of malignant cells with red blood cells. In chronic DIC these pathways are more balanced and compensatory mechanisms are able to restore platelets and coagulation factors. The diagnosis of DIC is made by decreased platelet count, increased fibrin related markers including fibrin degradation products, D-dimer, soluble fibrin, decreased fibrinogen, and increased Prothrombin Time (PT). Treatment of DIC should be focused on treating the primary cancer. Supportive therapy involves platelets transfusion, fresh frozen plasma (FFP) or prothrombin complex concentrate for patients with predominantly bleeding features and anticoagulation for patients with features of thrombosis.

Original languageEnglish (US)
Title of host publicationDisseminated Intravascular Coagulation (DIC)
Subtitle of host publicationClinical Manifestations, Diagnosis and Treatment Options
PublisherNova Science Publishers, Inc.
Pages143-153
Number of pages11
ISBN (Electronic)9781629483276
ISBN (Print)9781629483238
StatePublished - Jan 1 2013
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)

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