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)

The course of 76 consecutive patients with acute renal failure and severe intra-abdominal infection was reviewed to identify the microorganisms responsible, the factor precipitating reoperation, and prognostic indicators. Peritonitis occurred in 75 patients, 48 of whom had abscesses. Twenty-four patients (32%) survived. Anaerobes and fungi were commonly grown from blood. Gram-negative aerobic blood isolates were associated with the highest mortality. Leukocytosis, physical findings, and fever were factors that prompted reexploration whereas diagnostic procedures played an ancillary role. The finding of specifically correctable conditions at reoperation improved survival (P less than .05). Myocardial infarction and disseminated intravascular coagulation affected survival unfavorably whereas hyperalimentation had a favorable influence (P less than .05). Aggressive medical, nutritional, and surgical management results in improved survival rates in these patients.
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PMID:Intra-abdominal infection and acute renal failure. 63 17

Well-documented amniotic fluid embolism with survival is an uncommon occurrence. A case is reported with characteristic clinical findings in addition to electrocardiographic evidence of acute right heart strain, disseminated intravascular coagulation, and amniotic fluid debris in central venous blood. The impact of this complication on maternal mortality is emphasized. Aggressive therapy with attention to the basic principles of supportive care offers the best chance of survival.
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PMID:Amniotic fluid embolism with survival. 125 May 60

A 20-year-old female presented with sudden onset of abdominal pain, diarrhoea and vomiting progressing to fever, tachycardia and mild hypotension. Within 12 hours, a petechial rash appeared on the face and abdomen, spreading to the extremities. Laboratory findings confirmed the diagnosis of acute meningococcaemia. Clinical features of endotoxic shock, vasculitis and skin necrosis rapidly ensued. Aggressive treatment to control the septicaemia, disseminated intravascular coagulation and unstable cardiovascular state ultimately proved successful. Approximately 6 weeks later, amputation of some of the digits and extensive skin grafting were carried out in the Regional Burns Unit. However, serious psychological side effects gradually began to appear which required urgent psychiatric intervention. For an active young woman the challenge of coping with such a severe illness and coming to terms with the disability and disfigurement resulting from it was almost overwhelming. It was, perhaps, particularly hard because of the threat posed to her ambition to complete her nursing education and become a nurse. Little was found in the nursing literature on acute meningococcaemia. But this illness provides considerable challenges not only to those who suffer from it, but also to those who nurse them. A final brief review of published literature on acute meningococcaemia and the clinical manifestations and outcome of it is provided for those who wish to know more about it.
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PMID:Acute meningococcaemia: a case study. 232 67

A patient with metastatic gastric adenocarcinoma had progressive microangiopathic red blood cell changes, thrombocytopenia with increased marrow megakaryocytes, bleeding, altered mentation, and seizure. Coagulation parameters were inconsistent with disseminated intravascular coagulation; a clinical diagnosis of thrombotic thrombocytopenic purpura (TTP) was made. Plasmapheresis resulted in improvement on two separate occasions. The diagnosis of tumor-associated TTP should be considered in cancer patients. Plasmapheresis may be more effective than plasma transfusion alone in this syndrome, perhaps via removal of tumor-induced immune complexes from the circulation. Aggressive management of this complication seems justified in cancer patients for whom effective chemotherapy exists.
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PMID:Thrombotic thrombocytopenic purpura associated with metastatic gastric adenocarcinoma: successful management with plasmapheresis. 348 81

Rhabdomyolysis is a clinical disorder arising from skeletal muscle injury. Many potentially fatal complications may develop after rhabdomyolysis, including hyperkalemia, disseminated intravascular coagulation, and acute renal failure. Both traumatic and nontraumatic causes of rhabdomyolysis are seen. Frequently, nontraumatic rhabdomyolysis is associated with the use of common drugs. We report such a case--a patient afflicted with the neuroleptic malignant syndrome (NMS). NMS is characterized by fever, muscle rigidity, and neurologic changes after treatment with neuroleptic agents such as haloperidol. These symptoms may progress to rhabdomyolysis and acute renal failure. Many similar disease entities, especially those that display hyperpyrexia, resemble NMS. Thus, the diagnosis should rest on pertinent history as well as the recognition of these relevant clinical signs. Treatment should be directed toward averting the systemic complications of drug-induced rhabdomyolysis and renal failure. Discontinuation of the neuroleptic medication is imperative. Aggressive iv hydration, systemic and urine alkalinization, and therapy for life-threatening electrolyte abnormalities are all appropriate additional therapeutic goals. The use of dantrolene or bromocriptine may hasten recovery from NMS. Although mortality from NMS alone is unusual, NMS with concomitant renal failure carries a worse prognosis. The treatments outlined here may avert progressive renal failure and reduce mortality in patients with NMS-induced rhabdomyolysis and renal failure.
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PMID:The neuroleptic malignant syndrome and acute renal failure. 816 22

Primary infection with varicella-zoster virus usually is a mild, self-limiting childhood illness. However, certain rare but potentially life-threatening complications can be associated with the disease. Adults and immunosuppressed patients are at increased risk for these events. We report a case of a patient on chronic immunosuppressants with fulminant varicella infection complicated by rhabdomyolysis and disseminated intravascular coagulation. Mechanisms of muscle damage in viral diseases might be direct invasion of skeletal muscle and/or induction of harmful cytokines. Aggressive fluid therapy, alkalinization of urine and supportive measures correcting electrolyte imbalances, hypothermia and hypoxemia should result in preservation or complete restoration of renal function. Disseminated intravascular coagulation occurs in conjunction with various diseases and may range from mild laboratory abnormalities to fulminant lethal thrombosis and bleeding. Apart from elimination of the causative process therapeutic strategies are still highly disputed.
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PMID:Disseminated intravascular coagulation (DIC) and rhabdomyolysis in fulminant varicella infection--case report and review of the literature. 979 91

Transcatheter angiographic emobilisation has been used as an effective control of haemorrhage associated with pelvic fracture. Although few complications of this procedure have been reported, gluteal muscle necrosis occurs occasionally. We assessed the type of pelvic fracture, concomitant injury, embolic site, embolic materials, and outcome in cases of gluteal muscle necrosis associated with angiographic embolisation for pelvic fracture-related haemorrhage, and investigated the factors associated with the development of gluteal muscle necrosis, one of the fatal complications of transcatheter angiographic embolisation. Five out of the 151 patients (incidence, 3.3%) who underwent transcatheter angiographic embolisation for haemorrhagic shock due to pelvic fracture developed gluteal muscle necrosis after embolisation. The five cases had injury severity scores ranging from 26 to 59 (mean 46.4). Three patients died (mortality, 60%) of subsequent sepsis and disseminated intravascular coagulation. These cases showed that transcatheter angiographic embolisation with gelatin sponge and/or steel coil, while effectively controlling bleeding, may also result in gluteal muscle necrosis. Aggressive management including intraarterial antibiotic treatment may have a role, but our numbers are too small to confirm this.
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PMID:Gluteal muscle necrosis following transcatheter angiographic embolisation for retroperitoneal haemorrhage associated with pelvic fracture. 1116 98

We report an infant with congenital tuberculosis who presented with fulminant septic shock, disseminated intravascular coagulation and respiratory failure. Aggressive resuscitation and supportive care and prompt initiation of antituberculosis medications led to resolution of the shock state. We reviewed six other cases with a similar presentation. Congenital tuberculosis should be in the differential of the infant presenting acutely with sepsis syndrome.
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PMID:Congenital tuberculosis presenting as sepsis syndrome: case report and review of the literature. 1133 72

Release of toxins in the organism trigger a cascade of biological and chemical events. The process involves a large number of molecules produced under genetic control in a perfectly regulated chronological order. Certain molecules (TNFx, IL-1, Il-2.) have inflammatory proprieties, generally producing systemic Inflammatory Response Syndrome (SIRS). Other less numerous molecules (IL-4, IL-10) have antiinflammatory actions. Finally, soluble receptors and these cytokines contribute to the decrease in the quantity of active cytokines at the receptor level. Dozens of other molecules, many of which remain to be fully understood, are also found in the blood stream. They can, for example, facilitate white cell adhesion (ICAM, VCAM, selectins.). Some of them (G-CSF. CM-CSF. IL-5) stimulate production of granulocytes, monocytes, eosinophils. More recently, certain peptides, like macrophage inhibiting factor (MIF) and procalcitonin (PCT) have been added to the list of molecules involved in bacterial infections. Coagulation factors are also very rapidly released in response to toxinic aggression triggering disseminated intravascular coagulation. Later, acute-hase inflammation proteins, such as C-reactive protein (CRP), haptoglobin, serum amyloid A, etc. are found in largely increased quantities. All these molecules are potential markers of inflammation. Only a few have however been retained for routine assay due to their fragility and their short-half life or due to analytical difficulties. CRP and PCT can however be used to differentiate viral infections from bacterial infections and are thus routinely used in clinical applications. In the second part of this review, we briefly discuss therapeutic perspectives for severe infections and septic shock. There have been many attempts to neutralize different cytokines but results have been disappointing to date. There are however many possibilities currently under study, particularly neutralization of endotoxins, immunomodulation, use of recombinant C and S proteins, etc.
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PMID:[Inflammatory cascade response to toxin release: therapeutic perspectives]. 1142 20

A 2-year-old female spayed domestic shorthair cat was examined because of lethargy, inappetance, vocalization, and abnormal aggressive behavior of 1 day's duration. The cat had been groomed the previous day with a d-limonene-based insecticidal shampoo. Skin lesions consisted of coalescing erythematous patches. Despite supportive care, the cat's condition deteriorated. Dermatohistopathologic changes included multifocal areas of acute coagulative epidermal necrosis. The dermis was infiltrated by a dense population of bacilli. d-Limonene toxicosis has been rarely described in dogs and cats. Toxic effects such as hypersalivation, ataxia, shivering, hypothermia, scrotal irritation, hypotension, and erythema multiforme major have been reported. Treatment for septicemia and disseminated intravascular coagulation, along with intensive supportive care, may be necessary.
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PMID:Acute necrotizing dermatitis and septicemia after application of a d-limonene-based insecticidal shampoo in a cat. 1236 86


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