{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T23:02:46Z","timestamp":1789772566296,"version":"4.0.1"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Despite disseminated intravascular coagulation (DIC) and thrombotic microangiopathy (TMA) sharing features of thrombocytopenia, organ dysfunction, and bleeding, the relationship between these two conditions remains unclear. We therefore conducted a post hoc analysis of post\u2010marketing surveillance data from Japan to evaluate the clinical characteristics of 2362 patients with DIC (TMA\u2010like phenotype DIC,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009217; and non\u2010TMA\u2010like phenotype DIC,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20092145) who received thrombomodulin alfa (TM\u2010\u03b1). TMA\u2010like phenotype DIC was defined as platelet count &lt;\u200915\u2009\u00d7\u200910\n                    <jats:sup>4<\/jats:sup>\n                    \/\u03bcL, hemoglobin &lt;\u200910\u2009g\/dL and lactate dehydrogenase &gt;\u2009500\u2009IU\/L. Approximately 9% of the registered infection\u2010associated cases of DIC were TMA\u2010like phenotype DIC. Patients with TMA\u2010like phenotype were younger and had more renal dysfunction and liver dysfunction than those with non\u2010TMA\u2010like phenotype. Regarding the hemostatic examinations, fibrin\/fibrinogen degradation products,\n                    <jats:sc>D<\/jats:sc>\n                    \u2010dimer, and thrombin\u2010antithrombin complex levels were higher in patients with TMA\u2010like phenotype than in those with non\u2010TMA\u2010like phenotype. Patients with TMA\u2010like phenotype had worse resolution of DIC and 28\u2010day survival rates than those with non\u2010TMA\u2010like phenotype; however, the coagulation and fibrinolysis parameters in both groups showed improvement after TM\u2010\u03b1 administration. These findings describe a clinically severe subgroup of infection\u2010associated DIC and should be interpreted as exploratory given that confirmatory TMA testing was unavailable.\n                  <\/jats:p>","DOI":"10.1111\/ejh.70289","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T04:20:47Z","timestamp":1786681247000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Thrombotic Microangiopathy\u2010Like Phenotype in Patients With Infection\u2010Associated Disseminated Intravascular Coagulation Treated With Thrombomodulin Alfa"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4196-3394","authenticated-orcid":false,"given":"Naoki","family":"Takezako","sequence":"first","affiliation":[{"name":"Department of Hematology National Hospital Organization Disaster Medical Center  Tokyo Japan"},{"name":"Department of Hematology Nerima Hikarigaoka Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4442-1137","authenticated-orcid":false,"given":"Fumiyo","family":"Komatsu","sequence":"additional","affiliation":[{"name":"Medical Affairs Department Asahi Kasei Therapeutics Corporation  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4916-7640","authenticated-orcid":false,"given":"Goichi","family":"Honda","sequence":"additional","affiliation":[{"name":"Department of Hematology Fukushima Medical University  Fukushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriaki","family":"Kawano","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Miyazaki Prefectural Miyazaki Hospital  Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshimasa","family":"Uchiyama","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine National Hospital Organization Takasaki General Medical Center  Takasaki Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuo","family":"Kawasugi","sequence":"additional","affiliation":[{"name":"Higashi Kawaguchi Hospital  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiji","family":"Madoiwa","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Medicine Tokyo Saiseikai Central Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2227-4737","authenticated-orcid":false,"given":"Kei","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Mie University Graduate School of Medicine  Tsu Mie 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