-Case Report-

Thrombocytopenia Involving Disseminated Intravascular Coagulation Due to Aortic Aneurysm and Immune Thrombocytopenia

Masahiro Sakaguchi¹, Nana Matsumoto¹, Shunichi Yasuda¹, Ayaka Moriyama¹, Takahiko Mine², Yasuhiro Kawase³, Masamitsu Shimizu⁴, Ryohei Hamakubo⁵, Eriko Morishita^6,7, Hidesaku Asakura⁸ and Norio Yokose¹

¹Department of Hematology, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
²Department of Radiology, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
³Department of Cardiovascular Surgery, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
⁴Department of Pulmonology, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
⁵Department of Gastroenterology, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
⁶Department of Hematology, Nippon Medical School, Tokyo, Japan
⁷Department of Clinical Laboratory Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Faculty of Health Sciences, Kanazawa University, Kanazawa, Japan
⁸Department of Hematology, Kanazawa University Hospital, Kanazawa, Japan

A 68-year-old man with a history of lung cancer, prostate cancer, inflammatory bowel disease, and aortic aneurysm was referred for evaluation of a sudden decrease in platelet count. Coagulation findings indicated a diagnosis of disseminated intravascular coagulation (DIC) due to aortic aneurysm. Because all DIC-related markers except platelet count improved with DIC therapy, immune thrombocytopenia (ITP) was suspected. His platelet count recovered with rituximab for steroid-resistant ITP. Since thrombocytopenia may have multiple causes, particularly when combined with DIC and ITP, appropriate treatment of each condition is required.

J Nippon Med Sch 2026; 93: 422-428

Keywords
disseminated intravascular coagulation (DIC), immune thrombocytopenia (ITP), aortic aneurysm, rituximab, heparin and tranexamic acid

Correspondence to
Masahiro Sakaguchi
m-sakaguchi@nms.ac.jp

Received, December 23, 2024
Accepted, May 27, 2025