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The Use of Ketoconazole in the Emergency Management of Disseminated Intravascular Coagulation Due to Metastatic Prostatic Cancer

1987; Lippincott Williams & Wilkins; Volume: 137; Issue: 5 Linguagem: Inglês

10.1016/s0022-5347(17)44330-8

1527-3792

Franklin C. Lowe, William J. Somers,

Prostate Cancer Diagnosis and Treatment

No AccessJournal of Urology1 May 1987The Use of Ketoconazole in the Emergency Management of Disseminated Intravascular Coagulation Due to Metastatic Prostatic Cancer Franklin C. Lowe and William J. Somers Franklin C. LoweFranklin C. Lowe More articles by this author and William J. SomersWilliam J. Somers More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)44330-8AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail The disseminated intravascular coagulation syndrome is an untoward side effect of metastatic adenocarcinoma of the prostate. In addition to appropriate replacement of blood, platelets and clotting factors, prompt treatment of the prostatic carcinoma is required to correct the underlying pathophysiological defect. Ketoconazole is the ideal method for hormonal manipulation for patients with life-threatening complications of prostatic carcinoma (disseminated intravascular coagulation and acute paraparesis/paraplegia) because of its prompt onset of action in decreasing circulating concentrations of androgens to castrate levels. Serum testosterone levels are castrate within 48 hours of the initiation of therapy with ketoconazole as opposed to a minimum of 10 to 14 days with estrogens. A patient with spontaneous bleeding from disseminated intravascular coagulation was treated with 400mg. ketoconazole every 8 hours and bleeding stopped within 48 hours. Ketoconazole is particularly valuable when a prompt therapeutic response is needed and orchiectomy is contraindicated because of bleeding diathesis (as in disseminated intravascular coagulation), delay in histological confirmation (as in acute paraparesis/paraplegia) or patient reluctance to undergo castration. © 1987 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited bySMITH M (2018) SUCCESSFUL TREATMENT WITH MITOXANTRONE CHEMOTHERAPY OF ACUTE DISSEMINATED INTRAVASCULAR COAGULATION DUE TO METASTATIC ANDROGEN INDEPENDENT PROSTATE CANCERJournal of Urology, VOL. 163, NO. 1, (248-248), Online publication date: 1-Jan-2000.Surya B and Provet J (2018) Manifestations of Advanced Prostate Cancer: Prognosis and TreatmentJournal of Urology, VOL. 142, NO. 4, (921-928), Online publication date: 1-Oct-1989. Volume 137Issue 5May 1987Page: 1000-1002 Advertisement Copyright & Permissions© 1987 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Franklin C. Lowe More articles by this author William J. Somers More articles by this author Expand All Advertisement PDF downloadLoading ...