Intravascular Coagulation in Autopsy Cases with Liver Diseases

Summary

184 autopsy cases with liver diseases were examined clinicopathologically with special reference to the incidence and distribution of microthrombi and classic thrombi in various organs.

Microthrombi and/or classic thrombi were found in one or more organs in 50.0% to 59.4% of the patients with various liver diseases. But only 4 among 184 patients had many microthrombi in more than three organs and the incidence of disseminated intravascular coagulation seemed to be low in autopsy cases with liver diseases. Incidence of microthrombi showed no significant difference in the groups with and without portal vein thrombosis.

Hemorrhage in the upper alimentary tracts of the patients with liver cirrhosis did not seem to develop by disseminated intravascular coagulation. Consumption of clotting factors in liver diseases seemed to occur by thrombus formation in portal vein and esophageal varices and by hemorrhage in various organs.

• References

• 1 Bloom AL. 1975; Intravascular coagulation and the liver. British Journal of Haematology 30: 1
• 2 Deutsch E. 1965; Blood coagulation changes in liver diseases. Progress in Liver Diseases 2: 69
• 3 Fletcher AP, Biederman O, Moor D, Alkjaersig N, Sherry S. 1964; Abnormal plasminogen-plasmin system activity (Fibrinolysis) in patients with hepatic cirrhosis. Its cause and consequences. Journal of Clinical Investigation 43: 681
• 4 Hillenbrand P, Parbhoo SP, Jedrychowsky A, Sherlock S. 1974; Significance of intravascular coagulation and fibrinolysis in acute hepatic failure. Gut 15: 83
• 5 Hörder MH. 1969; Consumption coagulopathy in liver cirrhosis. Thrombosis et Diathesis Haemorrhagica Suppl 36: 313
• 6 Krauss H, Liehr H, Grün M, Thiel H. 1973; Histological investigation of intravascular coagulation in rats with gradual occlusion of the portal vein. Beiträge zur pathologischen Anatomie und zur allgemeinen Pathologie 149: 84
• 7 Liehr H, Hörder MH, Mersch-Baumert K. 1971; Hämostasestörungen bei Leberzirrhose. Acta hepatospenologica 18: 166
• 8 Liehr H, Grün M, Thiel H, Brunswig D, Krauss H. 1972; Different stimuli to disseminated intravascular coagulation in liver diseases (Letter). Thrombosis et Diathesis Haemorrhagica 28: 325
• 9 Oka K, Tanaka K. 1978 Local fibrinolysis of esophagus and stomach as a cause of hemorrhage in liver cirrhosis. Unpublished data
• 10 Rake M, Flute PT, Shilkin KB, Lewis ML, Winch J, Williams R. 1971; Early and intensive therapy of intravascular coagulation in acute liver failure. Lancet 4: 1215
• 11 Roberts HR, Cederbaum AI. 1972; The liver and blood coagulation: Physiology and pathology. Gastroenterology 63: 297
• 12 Thomas DP. 1972; Abnormalities of platelet aggregation in patients with alcoholic cirrhosis. Annals of the New York Academy of Sciences 201: 243
• 13 Tytgat GN, Collen D, Verstraete M. 1971; Metabolism of fibrinogen in cirrhosis of the liver. Journal of Clinical Investigation 50: 1960
• 14 Verstraete M, Vermylen J, Collen D. 1974; Intravascular coagulation in liver disease. Annual Review of Medicine 25: 447
• 15 Walls WD, Losowsky MS. 1971; The hemostatic defect of liver disease. Gastroenterology 60: 108