# Disseminated Intravascular Coagulation Following ¹⁷⁷Lu-Dotatate Therapy in a Patient With Metastatic Midgut Neuroendocrine Tumour: A Case Report

## TL;DR

A patient with a neuroendocrine tumor developed disseminated intravascular coagulation after Lu-Dotatate therapy, which improved with corticosteroids.

## Contribution

Identifies disseminated intravascular coagulation as a rare subacute complication of Lu-Dotatate therapy.

## Key findings

- A patient developed disseminated intravascular coagulation five weeks after Lu-Dotatate therapy.
- Corticosteroid treatment led to resolution of coagulation abnormalities.
- DIC is a rare but possible subacute complication of Lu-Dotatate therapy.

## Abstract

Peptide receptor radionuclide therapy (PRRT) is an expanding field with ¹⁷⁷Lu-Dotatate emerging as a treatment for midgut neuroendocrine tumours. Haematological side effects are infrequent, and the treatment is generally well tolerated. We present the case of a 70-year-old male patient who developed spontaneous bruising five weeks after his first dose of ¹⁷⁷Lu-Dotatate, with investigations consistent with disseminated intravascular coagulation (DIC). After initially requiring substantial transfusion support, the patient's DIC resolved with the commencement of corticosteroid therapy. This case suggests that DIC may be a rare subacute complication of ¹⁷⁷Lu-Dotatate, and that corticosteroids could be an effective component of management in such instances.