Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In this prospective study of 50 patients, 36 of whom developed the adult respiratory distress syndrome (ARDS), early and intense complement activation was demonstrated. These patients were at risk of the ARDS because of multiple injuries, major abdominal surgery, acute pancreatitis, severe burns, or disseminated intravascular coagulation. Abnormal C3 consumption (as measured by the C3d/C3 ratio) and elevated plasma C5a-like activity (as measured by a leukocyte aggregation assay) were associated with, respectively, 84 and 86% of cases of ARDS. Both tests were more sensitive indicators of complement consumption than were assays of total hemolytic complement activity (CH50) or total C3. The C3d/C3 ratio showed a close, inverse correlation with CH50 in 47 healthy subjects, and was increased in 12 control patients after minor surgery. The C5a-like activity was found only in patients at risk of ARDS; it was highly associated with clinical conditions that predispose to the ARDS, but it cannot be considered as a real predictor of ARDS occurrence in these patients. Sequential samples from both sides of the pulmonary circulation showed initial pulmonary clearance followed by the release of C5a-like activity. No simultaneous changes in C3 levels were found, suggesting the possible presence of modulating factors. These observations suggest that other factors (e.g., hypoxia and metabolic cascades) may influence the development of ARDS.
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PMID:Complement activation in patients at risk of developing the adult respiratory distress syndrome. 650 4

The coagulation changes observed in acute pancreatitis were studied clinically and those changes observed in acute experimental pancreatitis were compared with those after the intravenous infusion of pancreatic juice and ascitic fluid exudate obtained from bile-induced pancreatitis in dogs. The coagulation changes observed in six among 37 patients with acute pancreatitis and half of them died. Those changes observed clinically were either hypercoagulability or hypocoagulability. The coagulation changes after trypsin-induced acute experimental pancreatitis, elastase and autologous bile showed an indication of consumption coagulopathy. The effect upon blood coagulation after the intravenous injection of pancreatic juice included decreased platelet counts and plasma fibrinogen levels, prolonged partial thromboplastin and prothrombin time. The intravenous injection of pancreatic exudate produced greater changes than did those of an equal amounts of pancreatic juice. There was a shortening of E.L.T. and a marked increase in F.D.P. pancreatic exudate which accumulated during acute pancreatitis may contains a toxic substance or substances which contribute to the consumption of coagulation factors.
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PMID:[Disseminated intravenous coagulation in acute necrotizing pancreatitis]. 667 61

Factor VIII-related antigen (VIIIR:Ag) was consistently higher than factor-VIII procoagulant activity (VIII:C) in 57 patients with clinical conditions characterized by acute-phase reactions. Two different methods for measuring VIII:C (one- and two-stage assays) and VIIIR:Ag (electroimmunodiffusion and immunoradiometric assay) gave concordant results in the majority of cases. In 43% of plasma samples, crossed immunoelectrophoresis in agarose gel was characterized by the appearance of an additional, fast-moving precipitin peak which was immunologically identical with the major, slower-moving VIIIR:Ag peak. The fast-moving peak was detected in all the patients with clinical conditions typically associated with increased plasma proteolysis (DIC, acute pancreatitis, during thrombolytic therapy). It was present in a smaller proportion of cases with liver and renal failure and malignancies and in the post-operative period. The additional VIIIR:Ag peak is thought to be the result of in vivo factor VIII/von Willebrand factor fragmentation by proteolytic enzymes.
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PMID:Alterations of factor VIII von Willebrand factor in clinical conditions associated with an increase in its plasma concentration. 679 81

The autopsy of a 10-month-old infant girl who died suddenly after a 2-day illness revealed acute pancreatitis and DIC. While the definitive etiology remains unknown, retention of pancreatic juice accompanying proliferation of papillary epithelium within the pancreatic duct adjacent to the ampulla Vater was suggested. Acute interstitial pancreatitis was assumed to have resulted from suppurative inflammation of the pancreatic duct. DIC was probably caused by the release of pancreatic enzymes.
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PMID:Sudden death due to infantile pancreatitis. 713 2

The Shwartzman reaction was first described more than 50 years ago and two types, the generalized and the localized, were established in the early 1930s. Studies were mostly related to experimental pathology or immunology, and its significance in clinical medicine was initially obscure though thought to be obstetrically relevant. It is thought that the generalized type has a relation to human disease and that disseminated intravascular coagulation in man is really the counterpart of the generalized Shwartzman reaction in animals. The localized type on the other hand does not have obvious practical clinical pathological significance and tumor necrosis may be the only real example which is commonly seen. Further studies on the Shwartzman reaction relevant to human pathology have, however, suggested that it could be applied to several diseases, the pathogenesis of which was still obscure. The significance seems, however, different from either the generalized or localized type of reaction and so a proposal of the incidence of a third type--'univisceral' or 'single organ' Shwartzman reaction is made. Acute liver necrosis, Waterhouse-Friderichsen's syndrome, haemolytic uraemic anemia, idiopathic pulmonary haemorrhage, acute pancreatitis, acute pituitary necrosis and pseudomembranous colitis all seem to have features suggesting that they could be clinical manifestations of this type of Shwartzman reaction with focal intravascular coagulation.
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PMID:The Shwartzman reaction: a review including clinical manifestations and proposal for a univisceral or single organ third type. 719 6

The coagulation changes observed in acute experimental pancreatitis were compared with those after the intravenous infusion of pancreatic juice and ascitic fluid exudate obtained from bile-induced pancreatitis in dogs. The coagulation changes after acute pancreatitis was induced by the intraductal injection of autologous bile, trypsin or elastase showed decreased platelet counts, decreased plasma fibrinogen levels, prolonged partial thromboplastin and prothrombin times, shortened euglobulin clot lysis time and increased fibrin degradation products. Multiple microemboli were observed in the lung and, occasionally, in the kidney, an indication of consumption coagulopathy. The effects upon blood coagulation after the intravenous injection of pancreatic juice included decreased platelet counts, decreased plasma fibrinogen levels and prolonged partial thromboplastin and prothrombin times. The intravenous injection of pancreatic exudate produced greater changes than did those of an equal amount of pancreatic juice. There was a shortening of euglobulin clot lysis time and a marked increase in fibrin degradation products. Pancreatic exudate which accumulates during acute pancreatitis may contain a toxic substance or substances which contribute to the consumption of coagulation factors during acute pancreatitis.
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PMID:The effects upon blood coagulation in dogs of experimentally induced pancreatitis and the infusion of pancreatic juice. 726 8

Acute Pancreatitis is seen very frequently. We report a case of acute pancreatitis with a rare complication of disseminated intravascular coagulation (DIC), who recovered completely.
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PMID:Acute pancreatitis with disseminated intravascular coagulation. 800 87

Proteolytic enzymes, lipase, kinins, and other active peptides liberated from the inflamed pancreas convert inflammation of the pancreas, a single-organ disease of the retroperitoneum, to a multisystem disease. Adult respiratory distress syndrome, in addition to being secondary to microvascular thrombosis, may be the result of active phospholipase A (lecithinase), which digests lecithin, a major component of surfactant. Myocardial depression and shock are suspected to be secondary to vasoactive peptides and a myocardial depressant factor. Coagulation abnormalities may range from scattered intravascular thrombosis to severe disseminated intravascular coagulation. Acute renal failure has been explained on the basis of hypovolemia and hypotension. The renin-angiotensin alterations in acute pancreatitis (AP) as mediators of renal failure need to be studied. Metabolic complications include hypocalcemia, hyperlipemia, hyperglycemia, hypoglycemia, and diabetic ketoacidosis, of which hypocalcemia has been long recognized as an indicator of poor prognosis. The pathogenesis of hypocalcemia is multifactorial and includes calcium-soap formation, hormonal imbalances (e.g., parathyroid hormone, calcitonin, glucagon), binding of calcium by free fatty acid-albumin complexes, and intracellular translocation of calcium. Subcutaneous fat necrosis, arthritis, and Purtscher's retinopathy are rare. The various prognostic criteria of AP and other associated laboratory abnormalities are manifestations of systemic effects. Early recognition and appropriated management of these complications have resulted in improved prognosis of severe AP.
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PMID:Acute pancreatitis: a multisystem disease. 804 85

We reported a case of acute pancreatitis occurring during administration of valproic acid for epilepsy. About four years prior to the first onset of acute pancreatitis, treatment with valproic acid for his seizures was started. The first pancreatitis improved by conservative therapy within a week. He continued valproic acid after the first episode. Two months later, the second acute pancreatitis occurred. The second episode was complicated with disseminated intravascular coagulation, but responded to conservative therapy. After the second episode, the valproic acid was discontinued and pancreatitis has not recurred. Pancreatitis associated with valproic acid may be severe, and therefore valproic acid should be used with caution.
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PMID:[A case of acute pancreatitis during administration of valproic acid]. 839 36

1. Nafamostat mesilate (NM) is a novel serine-protease inhibitor used for the treatment of acute pancreatitis and disseminated intravascular coagulation. Recently, NM has been reported to cause hyperkalemia due to reduced urinary excretion of potassium (K). 2. This review briefly summarizes the roles of the cortical collecting duct (CCD) in the renal K excretion. 3. In vitro microperfusion technique was applied to examine whether NM, and its two metabolites, p-guanidinobenzoic acid (PGBA) and 6-amidino-2-naphthol, directly act on the CCD. 4. It was demonstrated that these compounds act mainly on the apical membrane of the collecting duct cell in the CCD and inhibit the amiloride-sensitive sodium (Na) conductance, resulting in an inhibition of K secretion. PGBA had the most potent action. 5. This direct action of these two metabolites, rather than NM, could contribute to the NM-induced hyperkalemia.
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PMID:Mechanisms of hyperkalemia caused by nafamostat mesilate. 874 49


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