{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T17:15:16Z","timestamp":1774890916205,"version":"3.50.1"},"reference-count":10,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T00:00:00Z","timestamp":1664323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Interdisciplinary Centre for Clinical Research (IZKF) Jena","award":["IZKF-CSPOA19-BG"],"award-info":[{"award-number":["IZKF-CSPOA19-BG"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Disseminated intravascular coagulation (DIC) is a systemic disease characterized by simultaneous thrombosis, bleeding, and partially excessive fibrinolysis. Systemic shock, trauma, bacterial toxins, and procoagulants-expressing solid and hematologic malignancies are common causes of this life-threatening hemorrhagic complication and often require treatment in intensive care units. We describe a case of an elderly man with recurrent severe bleeding events in the cause of DIC, including epistaxis, hemoptysis, hematuria, and gastrointestinal bleeding. Laboratory investigations revealed elevated prostate-specific antigen (PSA), suggesting an underlying prostate cancer. Despite intensified coagulatory therapy, the coagulation disorder could not be stabilized. A single injection of degarelix, a gonadotropin-releasing hormone (GnRH) receptor antagonist, led to rapid stabilization of the coagulation and decreased PSA within days. One year after initiating androgen-deprivation therapy, there were recurrent transfusion-requiring bleeding events, and a concomitant PSA increase occurred, suggesting metastatic castration-resistant disease associated with DIC. This case emphasizes DIC as a possible primary phenomenon and indicator for the progression of the underlying malignancy, as well as the importance of etiological therapies in the management of DIC.<\/jats:p>","DOI":"10.3390\/diagnostics12102342","type":"journal-article","created":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T20:58:47Z","timestamp":1664398727000},"page":"2342","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Recurrent Disseminated Intravascular Coagulation in Metastatic Castration-Resistant Prostate Cancer: A Case Report"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3596-1437","authenticated-orcid":false,"given":"Benjamin","family":"Giszas","sequence":"first","affiliation":[{"name":"Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital, Friedrich-Schiller-University Jena, Am Klinikum 1, 07747 Jena, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Fritzenwanger","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division of Medical Intensive Care, Jena University Hospital, Friedrich-Schiller-University Jena, Am Klinikum 1, 07747 Jena, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3084-8654","authenticated-orcid":false,"given":"Marc-Oliver","family":"Grimm","sequence":"additional","affiliation":[{"name":"Department of Urology, Jena University Hospital, Friedrich-Schiller-University Jena, Am Klinikum 1, 07747 Jena, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Stallmach","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital, Friedrich-Schiller-University Jena, Am Klinikum 1, 07747 Jena, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7696-475X","authenticated-orcid":false,"given":"Philipp A.","family":"Reuken","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital, Friedrich-Schiller-University Jena, Am Klinikum 1, 07747 Jena, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1055\/s-0037-1616068","article-title":"Towards Definition, Clinical and Laboratory Criteria, and a Scoring System for Disseminated Intravascular Coagulation","volume":"86","author":"Taylor","year":"2001","journal-title":"Thromb. Haemost."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"8S","DOI":"10.1177\/1076029618806424","article-title":"Disseminated Intravascular Coagulation: An Update on Pathogenesis, Diagnosis, and Therapeutic Strategies","volume":"24","author":"Papageorgiou","year":"2018","journal-title":"Clin. Appl. Thromb. Hemost."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1055\/s-0039-1687890","article-title":"Disseminated Intravascular Coagulation in Cancer: An Update","volume":"45","author":"Levi","year":"2019","journal-title":"Semin. Thromb. Hemost."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.beha.2008.12.009","article-title":"Procoagulant Mechanisms in Tumour Cells","volume":"22","author":"Falanga","year":"2009","journal-title":"Best Pr. Res. Clin. Haematol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Hell, L., D\u00e4ullary, T., Burghart, V., Mauracher, L.-M., Grilz, E., Moser, B., Kramer, G., Schmid, J.A., Ay, C., and Pabinger, I. (2021). Extracellular Vesicle-Associated Tissue Factor Activity in Prostate Cancer Patients with Disseminated Intravascular Coagulation. Cancers, 13.","DOI":"10.3390\/cancers13071487"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.ccc.2005.02.001","article-title":"Disseminated Intravascular Coagulation: What\u2019s New?","volume":"21","author":"Levi","year":"2005","journal-title":"Crit. Care Clin."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1111\/j.1464-410X.2008.08183.x","article-title":"The Efficacy and Safety of Degarelix: A 12-Month, Comparative, Randomized, Open-Label, Parallel-Group Phase III Study in Patients with Prostate Cancer","volume":"102","author":"Klotz","year":"2008","journal-title":"BJU Int."},{"key":"ref_8","first-page":"182","article-title":"Changes in Alkaline Phosphatase Levels in Patients with Prostate Cancer Receiving Degarelix or Leuprolide: Results from a 12-Month, Comparative, Phase III Study: Alp Levels in Patients With Prostate Cancer Receiving Degarelix or Leuprolide","volume":"106","author":"Tombal","year":"2009","journal-title":"BJU Int."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1056\/NEJMoa1903307","article-title":"Apalutamide for Metastatic, Castration-Sensitive Prostate Cancer","volume":"381","author":"Chi","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_10","unstructured":"(2022, April 27). Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft DK, AWMF): S3-leitlinie Prostatakarzinom L, 2021, AWMF Registernummer: 043\/022OL. Available online: https:\/\/www.awmf.org\/uploads\/tx_szleitlinien\/043-022OLl_S3_Prostatakarzinom_2021-10.pdf."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/10\/2342\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:40:57Z","timestamp":1760143257000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/10\/2342"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,28]]},"references-count":10,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["diagnostics12102342"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics12102342","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,28]]}}}