Decreased factor XIII activity and haptoglobin may be markers of enhanced-fibrinolytic-type disseminated intravascular coagulation status: Case report.

RATIONALE

Aortic aneurysms are often accompanied by enhanced-fibrinolytic-type disseminated intravascular coagulation (DIC), but markers to adequately assess DIC status remain lacking.

PATIENT CONCERNS

An 80-year-old man scheduled for thoracic endovascular aortic repair for aortic aneurysm was diagnosed with enhanced-fibrinolytic-type DIC. The concern was whether surgery could be safely performed in a state of enhanced-fibrinolytic-type DIC with a bleeding tendency.

INTERVENTIONS

He was treated with a combination of heparin and tranexamic acid.

OUTCOMES

DIC was well controlled and the surgery was performed safely. However, DIC worsened again postoperatively. Since no severe bleeding symptoms were observed, no therapeutic intervention for DIC was performed postoperatively. During this period, coagulation tests including factor XIII activity and haptoglobin were followed over time to clarify the relevance of these markers.Factor XIII activity was decreased and haptoglobin was mildly decreased in DIC. Improvement of DIC led to normalization of both markers. Re-exacerbation of DIC led to decreased factor XIII activity and mildly decreased haptoglobin.

LESSONS

Factor XIII activity and haptoglobin appear to represent useful markers of DIC status.