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Table 2 Clinical features of previously reported cases requiring hemodialysis with DIC induced by aortic aneurysm/dissection, in which tranexamic acid was administered

From: Oral tranexamic acid combined with low molecular weight heparin only during dialysis sessions successfully controlled chronic disseminated intravascular coagulation associated with aortic aneurysm and aortic dissection in a dialysis patient: a case report with literature review

 

Case 1

Case 2

Case 3

Case 4

Author

Gatate et al. [2]

Kimura et al. [12]

Tanaka et al. [23]

Eguchi (the present case)

Patient age and sex

71, female

67, male

72, male

94, male

Cause of DIC

Aortic dissection

Aortic dissection

Aortic aneurysm

Aortic aneurysm and aortic dissection

Laboratory data on DIC

 Platelet counts (/μL)

98000

72000

46000

84000

 FDP/D-dimer (μg/mL)

Not available/57.6

109.7/78.5

113.5/53.84

148/73.6

 Fibrinogen (mg/dL)

< 50

110

113

175

 PT-INR

1.37

Not available

1.14

1.14

 Antithrombin (%)

Not available

89.9

88

69

 TAT/PIC (ng, μg/mL)

60.0/9.1

60.0/9.8

Not available

30.7/9.3

 α2-PI (%)

Not available

47

Not available

69

Treatment

 Surgical procedures

Not performed

Not performed

Not performed

Not performed

 Anticoagulants

UH 4000 units every dialysis session

LMWH 4000 aXa units daily DIV

Danaparoid 1250 units IV × 2 times/week

LMWH 300 aXa units/one shot and 150 aXa units/hour every dialysis session

LMWH 1250 aXa units/one shot every dialysis session

 Dosage and route of administration of tranexamic acid

(The duration of administration)

1500 mg daily PO

2000 mg daily PO

(43 months)

1500 mg daily IV

1500 mg daily PO

500 mg daily PO

(9 months)

150 mg PO × 3 times/week

(2.5 months)

750 mg daily PO

(15 months)

 Synthetic proteinase inhibitors

Nafamostat mesilate 190 mg daily DIV (ineffective)

Not used

Camostat mesilate 300 mg daily PO → 900 mg daily PO

Nafamostat mesilate 50 mg every dialysis session (ineffective)

Outcome

 DIC

Well controlled

Well controlled

Well controlled

Well controlled

 Alive/dead

Died of lower extremity infection

Died of cerebellar hemorrhage

Alive

Died of lower extremity infection

 Adverse effects associated with tranexamic acid

None

None

None

None

  1. aXa anti-factor Xa, α2-PI α2 plasmin inhibito, DIC disseminated intravascular coagulation, DIV drip infusion, FDP fibrin and fibrinogen degradation product, IV intravenous, LMWH low molecular weight heparin, PIC plasmin-α2 plasmin inhibitor complex, PO per oral, PT-INR prothrombin time international normalized ratio, TAT thrombin-antithrombin complex, UH unfractionated heparin