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