Disseminated intravascular coagulation with multiple arterial thromboses responding to antithrombin-III concentrate infusion

Disseminated intravascular coagulation (DIC) most often manifests itself through hemorrhagic episodes following thrombotic consumption of platelets and coagulation factors in the microvasculature. Rarely patients suffer major arterial thrombosis in the setting of disseminated intravascular coagulation. We treated such a patient, whose thrombotic diathesis was refractory to traditional heparin and fresh frozen plasma therapy, with infusion of anti-thrombin III concentrate. The response was a prompt improvement in both clinical and laboratory parameters followed by recurrent thrombosis when concentrate therapy was discontinued. This is the first reported case where DIC complicated by major arterial thrombosis was treated with antithrombin III concentrate. Our findings demonstrate that antithrombin III concentrates are useful in treating patients with DIC complicated by major arterial thrombosis.