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

Acute disseminated intravascular coagulation (DIC) has been reported following thrombus formation in various clinical settings. A patient developed DIC due to the formation of a large intracapsular hematoma following percutaneous renal biopsy. To our knowledge, this complication has not been previously reported. The coagulopathy was reversed by surgical removal of the hematoma. This diagnosis should be considered in patients with bleeding after renal biopsy.
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PMID:Disseminated intravascular coagulation following percutaneous renal biopsy. 179 96

Abnormal prothrombin was detected by latex agglutination method in the plasma of the patients with acute hepatic failure (AHF) at significantly higher rate (82% of fulminant hepatitis and 100% of subacute hepatitis) than in acute hepatitis (33%). The concentration of abnormal prothrombin was also significantly higher in acute hepatic failure. Since the concentration of abnormal prothrombin reversely correlated with that of hepaplastin test or prothrombin time, the measurement of plasma abnormal prothrombin seemed to be useful in monitoring the severity of acute hepatic injury. Interestingly, enzyme immunoassay which is specific for des-gamma-carboxy prothrombin (PIVKA-II) could not detect abnormal prothrombin in acute hepatic failure. Furthermore, in crossed immune-electrophoresis, the abnormal prothrombin in AHF and that in disseminated intravascular coagulation syndrome showed similar mobility differing from PIVKA-II. These results suggest that abnormal prothrombin can be a useful marker for AHF. Further characterization of the abnormal prothrombin may shed light on the mechanisms of severe coagulopathy in AHF.
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PMID:[Abnormal prothrombin in acute hepatic failure: the characterization and clinical evaluation]. 185 1

Thirty-six patients with chronic myeloproliferative disorders (CMPD) were studied as regards blood coagulation and fibrinolysis. These studies revealed various mild abnormalities: activated thromboplastin time (APTT) tended to prolong and the level of factor V decreased significantly. In several cases, the levels of D-dimer, thrombin-antithrombin III complex and plasmin-alpha 2-plasmin inhibitor complex were elevated compared to normal. These results suggest that abnormal coagulation system in the patients with CMPD is related to low grade disseminated intravascular coagulation. Many coagulation factors did not correlate with peripheral blood cell counts. Two patients with polycythemia vera were evaluated for several abnormalities of the coagulation system before and during treatment. Coagulation abnormalities persisted after hematologic control had been achieved. Our results suggest that patients with CMPD have a chronic state of abnormal blood coagulation system even after normalization of blood cell counts.
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PMID:[Abnormal blood coagulation and fibrinolysis in chronic myeloproliferative disorders]. 187 Feb 70

Trousseau's syndrome remains a widely unrecognized and untreated complication of cancer. The clinical spectrum of the coagulopathy extends from uncomplicated superficial thrombophlebitis to life threatening DIC. Due to the absence of specific biochemical markers associated with the hypercoagulable state, this diagnosis is often overlooked. Initial intravenous heparin followed by the chronic administration of subcutaneous heparin will usually prevent thromboembolic recurrence.
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PMID:Trousseau's syndrome. 189 85

Quantitative assay for fibrin monomer was done by use of a chromogenic substrate (S-2390, Coa set fibrin monomer). Samples from DIC prone patients with the underlying disease were assayed and classified into four groups. The pre DIC group showed higher FM values than the control with no laboratory coagulation abnormality, although the FDP . D-dimer showed no significant rise. FM assay is a useful marker for the detection of early coagulopathy in DIC. Administration of the AT III concentrate in the case of low level of plasma ATIII, thrombin . antithrombin complex I (TAT) caused a significant transient rise. The clinical course of DIC by TAT is often affected by the fluctuation of ATIII level in plasma, the usefulness of FM is that it reflects the real thrombin generation in DIC.
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PMID:[Fibrin monomer assay]. 192 Aug 60

A multicenter cooperative study was carried out involving 47 nationwide institutions in Japan to assess the efficacy and safety of LMWH (FR-860) in DIC. Fifty-six cases were challenged by FR-860 injection principally for 5 days at doses of 75 U/kg/day in group I (n = 27) and 150 U/kg/day in group II, (n = 29). Scoring points were defined based on the severity of bleeding symptoms, organ failures, and abnormal coagulation-fibrinolytic tests. Therapeutic effects of FR-860 were evaluated objectively according to degrees of improvement of these scores. Six patients (10.7%) died of their underlying diseases or complications other than DIC. Hemorrhagic side effects occurred in 1 and 3 cases of groups I and II, respectively. Bleeding symptoms improved excellently or moderately in 45.5 and 31.6% of the cases in groups I and II, respectively. Concerning organ failures and coagulation-fibrinolytic tests, remarkable improvement was observed in 31.6 and 66.7% of the cases of the group I, whereas they remained 14.3% and 51.7% in group II. The overall usefulness of FR-860 was 66.7% in group I and 58.6% in group II. These results demonstrate that FR-860 is effective in DIC at a dose of 75 U/kg/day.
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PMID:Treatment of disseminated intravascular coagulation with low molecular weight heparin. Research Group of FR-860 on DIC in Japan. 196 2

Three patients with consumption coagulopathy due to left atrial thrombosis associated with mitral valve disease are described. They had hypofibrinogenemia (0.7-1.7 g/L), mild thrombocytopenia (104-117 x 10(9)/L), and elevated fibrinos/fibrin degradation products (FDP) (20-64 micrograms/ml). Two patients had bleeding symptoms, and one of these also had two episodes of transient ischemic attack. One without bleeding symptoms had three episodes of transient ischemic attack and repeated retinal vein thrombosis. In two patients, preoperative anticoagulation with either heparin or nafamostat mesilate was followed by an increase in plasma fibrinogen level from 0.7 to 5.6 g/L and a decrease in FDP from 64 to 8 micrograms/ml in one patient, and fibrinogen from 1.0 to 2.8 g/L and FDP from 40 to 5 micrograms/mL in another patient. The mitral valve replacement and thrombectomy were performed uneventfully, and their coagulopathy disappeared thereafter. These three patients had a lower platelet count and a shorter platelet survival time than another three patients with mitral valve disease of a similar severity but without coagulopathy. Hemostatic evaluation should be performed in patients suspected of intracardiac thrombosis.
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PMID:Consumption coagulopathy associated with left atrial thrombosis. 205 Jun 2

In Thailand 29 patients were proved to have been bitten by arboreal green pit vipers: 24 by Trimeresurus albolabris and 5 by T. macrops. They were studied in order to define the clinical effects of envenoming, to characterize the haemostatic abnormalities and assess the efficacy of Thai Red Cross antivenom. T. macrops caused only local painful swelling, neutrophil leucocytosis and thrombocytopenia. T. albolabris caused more severe envenoming with local blistering and necrosis, shock, spontaneous systemic bleeding, defibrination, thrombocytopenia and leucocytosis. There was no evidence of disseminated intravascular coagulation, but fibrinolytic activity was increased. Platelet function was normal. The product of admission venom antigen concentration and the delay between bite and admission was significantly higher in defibrinated patients than in those without severe coagulopathy. Antivenom (5 ampoules intravenously) restored blood coagulability, but there was persistent venom antigenaemia, associated in some cases with recurrent coagulopathy. The literature on bites by south Asian green pit vipers of the genus Trimeresurus is reviewed; these bites are common medical problems and causes of morbidity. The identification of individual species is difficult, but may be important if antivenom is to be improved and used appropriately.
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PMID:Arboreal green pit vipers (genus Trimeresurus) of South-East Asia: bites by T. albolabris and T. macrops in Thailand and a review of the literature. 209 27

A multicenter cooperative study was carried out involving 47 nationwide institutes in Japan to assess the efficacy and safety of low molecular weight heparin (Fragmin) on DIC. Fifty-six DIC cases were challenged by Fragmin injection principally for 5 days with the doses of 75 U/kg/day in the I group (n = 27) and 150 U/kg/day in the II group (n = 29). Scoring points were defined based on the severity of bleeding symptoms, organ failures and abnormal coagulation-fibrinolytic examinations, and therapeutic effect of Fragmin was evaluated objectively according to the improvement degrees of these scores. Six cases (10.7%) died of the underlying diseases or complications other than DIC and hemorrhagic side effects occurred in 3.7 and 10.3% cases of the I and II groups, respectively. However, in bleeding symptoms, 45.5 and 31.6% cases of the I and II groups improved excellently or moderately. In organ failures and coagulation-fibrinolytic examinations, remarkable improvement was observed in 31.6 and 66.7% cases of the I group, while they remained 14.3 and 51.7% in the II group, respectively. The overall utility of Fragmin was 66.7% in the I group and 58.6% in the II group. These results demonstrate that Fragmin is effective on DIC with a dose of 75 U/kg/day.
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PMID:Clinical effect of low molecular weight heparin (fragmin) on DIC: a multicenter cooperative study in Japan. 216 78

Hemostatic abnormalities are present in a majority of patients with metastatic cancer. These abnormalities can be categorized as 1) increased platelet aggregation and activation, 2) abnormal activation of coagulation cascade, 3) release of plasminogen activator, and 4) decreased hepatic synthesis of anticoagulant proteins like Protein C and antithrombin III. The abnormal activation of coagulation cascade is mediated through release of Tissue Factor, Factor X activators, and other miscellaneous procoagulants from the plasma membrane vesicles of tumor cells. Macrophages of a tumor-bearing host also produce increased amounts of Tissue Factor. Production of Factor X activators and macrophage Tissue Factor is decreased by warfarin. The ability of the tumor cells to produce platelet-aggregating activity and plasminogen activator parallels their metastatic potential in animal and experimental systems. These studies also show that antiplatelet agents and antibodies against plasminogen activator can suppress the metastatic process. One or more laboratory abnormalities of hemostasis can be shown in up to 95% of patients with metastatic cancer. These abnormalities, however, are unable to predict subsequent development of thromboembolic or hemorrhagic complications. Clinical complications occur in 9-15% of the patients in the form of thrombotic or hemorrhagic disorders. The therapy of tumor-related coagulopathy should be guided by its clinical expression. Subclinical DIC should not be treated. Coumadin is generally ineffective for therapy of thrombosis in cancer patients. There is no consensus regarding the use of heparin in acute promyelocytic leukemia (APL). The defibrination in APL may be from disseminated intravascular coagulation as well as systemic fibrinolysis, as shown by decreased alpha 2 antiplasmin levels. In such cases, epsilon aminocaproic acid plus heparin therapy may be of benefit.
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PMID:Hemostasis in malignancy. 174 46


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