Severe Hemorrhagic Diathesis in a Patient with Prostat Adenocarsinoma and Diagnostic Approach

Disseminated intravascular coagulation, acquired hemophilia, and hyperfibrinolysis induced by prostate adenocarcinoma were first considered in the differential diagnosis of a patient who had been diagnosed with prostate adenocarcinoma and complicated with hemorrhage. Clinical progression and lack of response to other treatments directed us toward the diagnosis of hyperfibri- nolysis and tranexamic acid therapy was initiated. Clinical and laboratory findings resulted in a partial improvement, but the response was insufficient. This situation was associated with metastasis and not initiating the treatment for the primary disease. This case was presented to emphasize the importance of treatment arrangement on the basis of differential diagnosis for hemor- rhagic diathesis occurring in the clinical course of prostate adenocarcinoma.

Kaynakça

1. Albrechtsen, O.K. The fibrinolytic activity of human tissues. Br J Hae- matology 1957; 3(3): 284-91. [CrossRef]

2. Chesterman CN. The fibrinolitic system and haemostasis. Thromb Di- ath Hemorrh 1975; 34(2): 368-77.

3. Fay WP, Parker AC, Condrey LR, Shapiro AD. PAI-1 deficiency: char- acterization of a large kindred with a null mutation in the PAI-1 gene. Blood 1997; 90(1): 204-8.

4. Kessler CM. New perspectives in hemophilia treatment. Hematology Am Soc Hematol Educ Program 2005; 429-35. [CrossRef]

5. Inhibitor subcommitte of The Association of Haemophilia Centre Doc- tor Organization 2000; 6(1): 52-9.

6. Hudson A, Hunt BJ. A bleeding tongue-acute presentation of fibrino- lysis. International Journal of Laboratory Hematology 2007; 29(5): 393-4. [CrossRef]

7. Sharp AA, Path MC. Pathological fibrinolysis. Bri Med Bull 1964; 20(3): 240-5.

8. Kuhli C, Luchtenberg M, Scharrer I, Hattenbach LO. Massive subhya- loidal hemorrhage associated with severe PAI-1 deficiency. Graefe’ s Arch Clin Exp Ophthalmol 2005; 243(10): 963-6. [CrossRef]

9. Meade TW, Chakrabarti R, Haines AP, North WR, Stirling Y. Charac- teristics affecting fibrinolytic activity and plasma fibrinogen concentra- tions. Br Med J 1979; 20; 1(6157): 153-6.

Kaynak Göster