Prostate Cancer-Associated Disseminated Intravascular Coagulation with Excessive Fibrinolysis Treated with Degarelix

Shawn Y Ong; Josephine Taverna; Clint Jokerst; Thomas Enzler; Emad Hammode; Elisa Rogowitz; Myke R Green; Hani M Babiker

doi:10.1155/2015/212543

Prostate Cancer-Associated Disseminated Intravascular Coagulation with Excessive Fibrinolysis Treated with Degarelix

Case Rep Oncol Med. 2015:2015:212543. doi: 10.1155/2015/212543. Epub 2015 Nov 3.

Authors

Shawn Y Ong¹, Josephine Taverna², Clint Jokerst³, Thomas Enzler⁴, Emad Hammode⁴, Elisa Rogowitz⁵, Myke R Green⁶, Hani M Babiker⁷

Affiliations

¹ University of Arizona College of Medicine, 1501 N. Campbell Avenue, Tucson, AZ 85724, USA.
² University of Arizona Cancer Center, 1515 N Campbell Avenue, Tucson, AZ 85724, USA.
³ Department of Radiology, University of Arizona College of Medicine, 1501 N. Campbell Avenue, Tucson, AZ 85724, USA.
⁴ Department of Medicine, University of Arizona College of Medicine, 1501 N. Campbell Avenue, RM 6336, Tucson, AZ 85724, USA.
⁵ Scripps Health, Department of Medicine, 10666 N Torrey Pines Road, La Jolla, CA 92037, USA.
⁶ Department of Pharmacy Services, University of Arizona Medical Center, 1501 N Campbell Avenue, Tucson, AZ 85724, USA.
⁷ University of Arizona Cancer Center, 1515 N Campbell Avenue, Tucson, AZ 85724, USA ; Virginia G. Piper Cancer Center Clinical Trials at HonorHealth Research Institute, 10510 N 92nd Street, Suite 200, Scottsdale, AZ 85258, USA.

Abstract

Disseminated intravascular coagulation (DIC) with excessive fibrinolysis (XFL) is a rare and acute life-threatening variant of DIC in patients with prostate cancer. Patients present with coagulopathy, hypofibrinogenemia, and systemic bleeding. We describe a case of DIC XFL caused by prostate cancer (PC) successfully treated with a single injection of degarelix, a gonadotropin-releasing hormone (GnRH) receptor antagonist. This led to prompt control of the patient's coagulopathy within ten days of treatment. Our case highlights features of this rare and devastating hemorrhagic complication of PC along with a fast-acting and effective therapeutic drug option.