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Indium 111-Labeled Platelets Accumulation Over Abdominal Aortic Graft with Chronic Disseminated Intravascular Coagulation-A Case History

From the Department of Internal Medicine, Takasaki National Hospital, Takasaki, Japan

Katsumi Kaneko, M.D.

From the Department of Internal Medicine, Takasaki National Hospital, Takasaki, Japan

Yasuhiko Yamauchi, M.D.

From the Department of Internal Medicine, Takasaki National Hospital, Takasaki, Japan

Norio Kanazawa, M.D.

From the Department of Internal Medicine, Takasaki National Hospital, Takasaki, Japan

Toyoshi Sasaki, M.D.

From the Department of Internal Medicine, Takasaki National Hospital, Takasaki, Japan

Hideo Takeuchi, M.D.

From the Department of Internal Medicine, Takasaki National Hospital, Takasaki, Japan

The authors describe a seventy-six-year-old man with aortic graft, which became the focus of chronic disseminated intravascular coagulation (DIC). The patient had abdominal aortic aneurysm (AAA) and the size had increased up to 38 mm in diameter. The AAA was excised and replaced by Dacron graft. Ten months later, the DIC became chronic with renal dysfunction. Indium 111-labeled platelets scintigraphy showed increased accumulation of radioactivity over the graft. In the treatment of chronic DIC, low-dose subcutaneous heparin injection (5,000-10,000/day) was effective, and he was discharged. In this case there was also suspicion of lung cancer and recurrent aortic aneurysm, which were a more reasonable cause of chronic DIC. This case suggests that an aortic graft prosthesis may be a cause of localized chronic DIC and that indium 111-labeled platelets scintigraphy is useful for the detection of localized chronic DIC. Moreover, subcutaneous heparin administration may be effective for chronic DIC in patients with an abdominal aortic graft prosthesis.

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