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Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hemolytic uremic syndrome (HUS) is defined as microangiopathic hemolytic anemia, thrombocytopenia and uremia. It is an important cause of acute renal failure (ARF) in children all over the world. The present study was carried out to assess the incidence, clinical presentation, hematological and biochemical profile of children presenting with HUS from 1987 to 1990. Out of the 100 cases who presented with ARF 22 had HUS. A majority of these children were males below 1 year of age, and had a prodromal phase of mainly gastrointestinal manifestations lasting for about a week. Anemia was a constant feature followed by bleeding diathesis, mainly melena and purpura. Neurological manifestations included altered sensorium, irritability, coma, hypertensive encephalopathy and convulsions. Renal problems mainly included oliguria, hypertension, hematuria and edema. Investigations revealed thrombocytopenia and microangiopathic hemolytic anemia in all cases. Evidence of disseminated intravascular coagulation (DIC) was observed in 3 cases as decreased fibrinogen levels, increased fibrinogen degradation products and deranged clotting studies. Blood biochemistry revealed azotemia in all cases, hyponatremia in 5 cases, hypernatremia in 3 cases and hyperkalemia in 12 cases. Stool culture showed the presence of Shigella in 8, E. coli in 6 and Klebsiella in 4 cases. Out of 22 cases of HUS, 15 were treated conservatively; of these 2 died. Both of these deaths were due to DIC 7 children were put on peritoneal dialysis; only 1 child died in this group. Factors affecting the outcome were duration of oliguria, levels of blood urea and presence of encephalopathy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A clinico-hematological profile of hemolytic-uremic syndrome. 788 99

Still's disease is characterized by arthritis, fever, rash, lymphoid hypertrophy, leukocytosis, and anemia, often in association with thrombocytosis. We describe a patient with Still's disease and thrombocytopenia secondary to disseminated intravascular coagulation (DIC). Fifteen definite cases of DIC complicating Still's disease have been reported in the English literature. Most developed this complication while receiving high doses of salicylates in association with hepatic dysfunction. In a few, the coagulopathy has been associated with gold therapy. Our patient is only the second reported to develop DIC in the absence of drug therapy and the fourth reported to die from this complication. The clinical features of these 16 patients are summarized and proposed mechanisms of pathogenesis are reviewed.
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PMID:Disseminated intravascular coagulation in Still's disease. 789 78

From 1977 to 1990, 40 cases of bone marrow necrosis (BMN) were diagnosed among 10,856 (0.37%) consecutive bone marrow aspirations performed alone or with biopsy. All but two patients had underlying malignancies. Leukemia, nasopharyngeal cancer and cancer of unknown origin were the most common underlying diseases. Severe bone pain and fever were the predominant presenting symptoms. Anemia, schistocytes and leukoerythroblastosis were noted in the peripheral blood smears in 97% (37/38), 72% (22/32), and 66% (23/35) of the patients with cancer and BMN. Malignant cells were found in bone marrow aspirates or biopsy specimens in all but one of the patients. Varied degrees of disseminated intravascular coagulation were demonstrated in all of the 10 patients examined who displayed coagulation status. Four of seven patients with leukemia achieved complete remission after chemotherapy, and the survival time for the complete responders ranged from 10 months to eight years. The outcome of cancer patients with BMN who did not respond to chemotherapy was poor, with a median survival time of six weeks.
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PMID:Bone marrow necrosis in 38 adult cancer patients. 791 63

DIC-syndrome frequently associated with anemia is one of rheumatoid arthritis complications which runs latently in the presence of hypercoagulation and low fibrinolytic activity. The development of DIC syndrome in the above patients correlates with the process activity, pattern of the disease, is independent of rheumatoid arthritis stage and duration, the patients' age, immunological and serological characteristics. Concentrations of circulating immune complexes and DIC-syndrome are related in rheumatoid arthritis patients with anemia.
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PMID:[Laboratory diagnosis of disseminated intravascular blood coagulation syndrome in patients with rheumatoid arthritis]. 799 Mar 71

A 63-year-old woman was in hospital for persistent backache. Four months prior to admission she had been pointed out as having hypertension for the first time. On admission, she had anemia (hemoglobin 7.0 g/dl) with reticulocytosis, and a blood smear showed fragmented erythrocytes. A bone marrow aspirate disclosed erythroid hyperplasia and invasion of cancer cells. The chest roentgenogram showed a coin-lesion of the right lung and left pleural effusion. A diagnosis of microangiopathic hemolytic anemia (MAHA) associated with carcinomatosis was made, but the primary site of the cancer was unknown. Respiratory failure developed and the patient died a month later. Surprisingly, the autopsy revealed a malignant pheochromocytoma arising from the right adrenal gland with massive metastases to the lungs, liver, lymph nodes and systemic bones, and also disseminated intravascular coagulation (DIC). The DIC would probably account for the MAHA in this case. To our knowledge, this is the first reported case of malignant pheochromocytoma accompanied by MAHA.
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PMID:Malignant pheochromocytoma accompanied by microangiopathic hemolytic anemia: a case report. 800 27

We report on a female patient who attempted suicide by drinking 400 ml of 25% acetic acid. This amount is normally considered to be a lethal dose. Treatment was initiated about 2 hours after ingestion. Pain and shock were treated at first followed by the symptoms of haemolysis and renal failure. In severe corrosive injuries of the upper respiratory tract, intubation and ventilation are mandatory. After acid absorption, plasma separation is the quickest and most effective way of detoxication and removal of the products of haemolysis. In cases of severe haemolysis, exchange transfusion is necessary. In addition, careful management of the acid-base status is recommended. Disseminated intravascular coagulation or anaemia may develop. In this case, we used low dose heparin, erythrocyte transfusion and AT III substitution. In secondary renal failure, haemodialysis is recommended. When the acute intoxication has been treated, attention must be paid to fluid management and calorie intake. Care must be taken to exclude injury or stricture of the oesophagus or stomach. This case underlines the importance of immediate treatment of the haemolysis and detoxification with plasma separation with the immediate substitution of blood and clotting factors. In spite of an initial deterioration, the initiation of therapy led to a rapid improvement in circulation and renal function.
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PMID:[Acute oral acetic acid poisoning--case report]. 808 95

A post-dated intra-uterine growth retarded male Malay baby was born to a 30-year-old mother gravida II by Caesarean section. Her previous pregnancy ended in still-birth. The baby was severely asphyxiated at birth. He was intubated and immediately admitted to the neonatal intensive care unit. He had anasarca, anaemia, purpura and firm, massive hepatosplenomegaly. X-rays revealed ascites and bilateral metaphysiitis of the long bones. The haemoglobin level was 5.0 gm/dl and PCV 18.3%. Coombs' test was negative. Prothrombin time (PT) and partial thromboplastin time (PTT) were prolonged. The baby and mother were positive for Venereal Disease Research Laboratory (VDRL) and the treponema pallidum haemagglutination assay (TPHA) tests. The baby was actively resuscitated but expired at three and a half hours of life due to overwhelming sepsis associated with severe anaemia and disseminated intravascular coagulation.
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PMID:Case report--a neonate with nonimmune hydrops fetalis. 815 1

A case of multiple myeloma having plasmacytoma in the frontal bone and clivus is reported. A 68-year-old female was referred to our hospital because of a subcutaneous mass in the frontal region. She was diagnosed as having multiple myeloma 7 years ago and had been treated with chemotherapy. On admission, severe anemia, hyperproteinemia and elevation of serum lambda type immunoglobulin G (IgG) were pointed out. Plain skull X-rays showed numerous punched out lesions with a large bone defect of the frontal bone. CT scan and MRI revealed a mass lesion in the clivus in addition to a large epidural tumor in the frontal region. The encapsulated frontal epidural tumor was totally resected and cranioplasty was performed with resin. Histological diagnosis was plasmacytoma of IgG lambda type. The postoperative course was uneventful, and chemotherapy was continued. There was no tumor recurrence in the frontal region and no neurological deterioration, but she died of DIC 15 months after the operation. Twenty seven cases in the literature of multiple myeloma forming cranial or intracranial plasmacytoma were briefly reviewed. Although the prognosis of such cases is poor, total resection of medullary plasmacytoma is warranted especially in multiple myeloma patients who don't have another extramedullary plasmacytoma or plasma cell leukemia.
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PMID:[A case of multiple myeloma associated with a large subcutaneous mass in the frontal region]. 819 32

The clinical characteristics and treatment outcome in 40 children with acute promyelocytic leukemia (APL) treated at institutions participating in the Children's Cancer and Leukemia Study Group (CCLSG) were studied retrospectively. The median age at diagnosis was 8 years old. Bleeding diathesis was the predominant presenting symptom (90%), associated with laboratory findings of disseminated intravascular coagulation. Hepatomegaly, splenomegaly and lymphadenopathy were observed in 35%, 10%, and 15% of the cases, respectively. The median WBC count was 4.25 x 10(9)/l. Anemia (hemoglobin < 8 g/dl) and thrombocytopenia (< 30 x 10(9)/l) were present in more than half of the patients. Cytogenetic studies demonstrated the characteristic 15; 17 translocation in about 90% of the patients analyzed. Induction therapy consisted of cytosine arabinoside and an anthracycline, with or without other agents. Twenty-nine patients (73%) achieved complete remission (CR) while early fatal hemorrhage was the predominant cause of induction failure. The survival rates continued to decrease (28% at 3 years, 24% at 5 years, and 7.9% at 10 years) due to late marrow relapses. Anthracycline cardiotoxicity was fatal in three patients in remission. These clinical features of childhood APL should be taken into account in the development of new protocols.
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PMID:[Clinical characteristics and treatment results of acute promyelocytic leukemia in children (Children's Cancer and Leukemia Study Group)]. 823 Jul 51

Time course of changes in hemostasis were investigated in 68 rheumatoid arthritis (RA) patients. DIC syndrome and anemia were recorded in 23 and 20 patients, respectively. Three RA sufferers were free of anemia. A course of plasma-pheresis proved effective against DIC syndrome in 12 anemic and 2 nonanemic patients. Alleviation of DIC syndrome occurred in association with improvement in the red cell count and inhibition of rheumatoid process activity. In persistent DIC syndrome a trend to normalization of the above parameters was insignificant.
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PMID:[Plasmapheresis in the combined treatment of rheumatoid arthritis, complicated with anemia and blood coagulation disorders]. 830 87


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