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)

With the aim of temporarily assisting deterioration of liver function developing after surgery, extracorporeal blood purification therapy (EBPT) (plasma exchange and/or hemofiltration) was carried out in 26 postoperative patients. Initiation of EBPT was instituted according to the criteria of either a serum bilirubin greater than 15 mg/dl or Grade 2 or more coma. Plasma exchange was carried out 235 times in 23 patients and hemofiltration was performed 28 times for seven patients. In addition, hemodialysis and CAPD were linked in eight cases. Plasma exchange was found to control the progression of DIC and endotoxemia. Nine patients (35%) were weaned from EBPT. In the survivors the levels of blood ammonia and number of major complications were significantly lower compared to the nonsurvivors. Three patients treated only with hemofiltration were all lost. Among co-morbid factors present, incidences of renal failure, respiratory failure, and associated liver cirrhosis significantly increased poor clinical outcome on EBPT for postoperative liver failure.
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PMID:Temporary metabolic support by extracorporeal blood therapy for liver failure after surgery. 319 18

In eighteen patients with fulminant hepatic failure (FHF), in grade III or IV coma, both protein C antigen and activity were significantly decreased (0.35 +/- 0.03 u/ml and 0.35 +/- 0.03 u/ml respectively). There was a significant correlation between protein C antigen and activity (r = 0.61, p less than 0.01). Protein C antigen levels were inversely correlated with prothrombin time (r = -0.57, p less than 0.05) as were protein C activity levels (r = -0.57, p less than 0.05). There was also significant correlations between fibrinogen and protein C antigen (r = 0.69, p less than 0.01) and protein C activity (r = 0.61, p less than 0.01). These results demonstrate that the naturally occurring inhibitor of coagulation, protein C, is present at low levels in FHF and this is probably due to the lack of synthesis of the protein in the damaged liver. The low levels of protein C may make these patients more susceptible to the disseminated intravascular coagulation which is known to occur in FHF and this in turn will lead to a further reduction in protein C levels.
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PMID:The effect of fulminant hepatic failure on protein C antigen and activity. 338

Two cases of complete sagittal sinus occlusion with multiple brain hemorrhages, elevated intracranial pressure, and disseminated intravascular coagulation are described. These patients were successfully managed using pentobarbital-induced coma to ameliorate intracranial pressure elevation. This therapy was combined with monitoring of intracranial pressure and intermittent drainage of cerebrospinal fluid to further control intracranial pressure elevations. Thrombus and coagulopathy resolved with pentobarbital alone in one patient and after pentobarbital plus heparin therapy in the second patient. It is suggested that cases of severe distal sagittal sinus thrombosis with brain hemorrhage and intracranial hypertension may benefit from combined pentobarbital coma and intraventricular drainage. This allows for stabilization of bleeding tendencies before instituting heparin therapy when necessary. Management of sagittal sinus thrombosis with barbiturates or ventricular drainage is best performed in an intensive care unit environment with continuous monitoring of intracranial pressure and substantial electrophysiologic and neuroradiologic support.
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PMID:Treatment of sagittal sinus thrombosis associated with cerebral hemorrhage and intracranial hypertension. 338 62

Two infants are described with a fulminant disorder characterised by profound circulatory collaps and shock, generalised convulsions and unremitting coma, bleeding due to severe DIC, fever, diarrhoea, metabolic acidosis and renal and hepatic failure. Both infants died shortly after onset of the symptoms. Autopsy mainly revealed haemorrhages in different organs, anoxaemic lesions in the brain and a normal structure of liver and pancreas. No causative agent could be demonstrated. We believe that both patients suffered from haemorrhagic shock and encephalopathy, a mostly fatal disorder which has recently been described. Although the clinical and biochemical features are very distinctive, this syndrome is probably heterogeneous and its differentiation from some other disorders may be difficult. Its pathogenesis is unknown but there are some indications that intravascular activity of trypsin may play a role. During a study of the two families we obtained abnormal results of immunologic tests in most members: the interpretation of this finding remains conjectural. Haemorrhagic shock and encephalopathy may occur more frequently than the restricted literature on this subject suggests. Future studies will have to deal with the question of identity and pathogenesis.
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PMID:Haemorrhagic shock and encephalopathy. 373 33

In addition to the typical manifestations of thrombotic-thrombocytopenic purpura like thrombocytopenia, haemolysis, fever, coma and renal failure, signs of a beginning DIC could be seen in a patient after abdominal surgery. Haemostatic, cardiovascular and respiratory data are presented. Pulmonary angiography by using a Swan-Ganz-catheter revealed multiple filling defects reversible with therapy. Treatment with fresh whole blood aggravated thrombocytopenia. Daily infusions of fresh frozen plasma combined with heparinisation and antithrombin III because of DIC, induced haematologic remission. Renal failure and cerebral symptoms could not be influenced. Diagnosis, monitoring and therapy are discussed.
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PMID:[Partial remission of fulminant thrombotic-thrombopenic purpura (Moschcowitz syndrome) by infusion of fresh plasma]. 375 26

A 22-month-old female infant with an accidental methanol poisoning is presented. Her serum methanol level was 25 mg/dl. The clinical and biochemical features were as follows: coma, hyperventilation, metabolic acidosis, paralytic mydriasis, hypoglycemia, increased anion and osmolal gap, DIC, elevated CPK and LDH, anemia and abnormal EEG. She was treated with bicarbonated solutions and continuous infusion of ethanol. The pathophysiology, diagnosis and treatment of this poisoning is herein revised. DIC and enzymatic alterations are specially remarked.
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PMID:[Accidental methanol poisoning in an infant girl. Physiopathology, diagnosis and treatment]. 380 Jan 75

In an effort to ascertain important epidemiologic and prognostic risk factors, we analyzed 33 cases of Staphylococcus aureus meningitis occurring over an 8-year period (1976 to 1984). Staphylococcus aureus caused 6% of all bacterial meningitis at our University Hospital. Fifty percent of cases were pediatric and included 7 newborn infants, of whom 71% were either premature or had low birth weight. Major underlying diseases were: central nervous system (CNS) disorders (55%), endocarditis (21%, predominantly intravenous drug abusers), other sites of infection (27%), and prematurity (24%). Fifty-seven percent of patients were bacteremic and 41% of those had concomitant bacteriuria. Hypoglycorrhachia was present in 27% of cases, positive cerebrospinal fluid (CSF) Gram stain in 20%, disseminated intravascular coagulation (DIC) in 19%, and methicillin-resistant organisms in 18%. Cerebrospinal fluid cultures remained positive for a protracted period (mean, 6.7 days) regardless of the presence or absence of a CNS shunt. Overall mortality was 21%. Favorable outcomes were associated with the eventual presence of sterile CSF (15.4% vs. 100% mortality) and the removal of foreign bodies (10% vs. 67% mortality). Mortality was also associated (p less than 0.5) with the presence of diabetes mellitus, age greater than 60, obtundation or coma on presentation, bacteremia, or DIC. Cure correlated (p less than .05) with CNS shunt-associated infections, age less than 1, normal neurologic examinations on presentation, or the absence of DIC or bacteremia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Staphylococcus aureus meningitis: a broad-based epidemiologic study. 382 85

A review and follow-up study of 21 Chinese infants who had pneumococcal meningitis showed a mortality of 23.8% and high morbidity in survivors. Severe meningitis and delay in treatment as reflected by the presence of coma, pneumonia, disseminated intravascular coagulation, and lumbar CSF protein of over 368 mg% and glucose of lower than 10 mg% at the time of diagnosis were associated with fatality. Although the pneumococcus was sensitive to Penicillins which were given at usually recommended dosages and duration in these infants, the morbidity in survivors was high, and seemed to be associated with the presence of focal neurological abnormalities at the time of diagnosis, slow response in fever to treatment, short duration of afebrile period before discontinuation of antibiotics, and incompletely normal CSF parameters at the time of cessation of antibiotics. Serially sterile lumbar CSF did not guarantee against recrudescence of meningitis after cessation of antibiotics. The lack of uniformity in treating and monitoring these patients and suggested management are discussed.
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PMID:Pneumococcal meningitis in infants. 383 49

By damaging cell membrane integrity, acute rhabdomyolysis leads to electrolyte shifts according to the concentration gradients and the liberation of intracellular substances. Diagnosis is confirmed by the presence of a high serum creatinkinase activity (CK) and myoglobinuria. For clinical purposes myoglobinuria is demonstrated by a blood-positive dipstick in the absence of hematuria or hemoglobinuria. Rhabdomyolysis is usually acquired and is rarely due to hereditary enzyme defects. The authors report on 61 patients admitted in the last 15 years with rhabodomyolysis. In the past 4 1/2 years the diagnosis was suggested by CK greater than 5000U/1 in 49 patients, representing 1.6% of all admissions in the departments of medicine and surgery. Originally described in crush situations, rhabdomyolysis has been observed with increasing frequency as a consequence of muscular stress and self crush due to coma or hemi- and paraplegia during the last decades. 24% of the patients with this diagnosis had had an intoxication, and in 70% there were multiple simultaneous causes. Autoimmune diseases, infections of bacterial, viral and fungal origin, endocrinopathies, and thermic and ischemic injuries can also provoke rhabdomyolysis. As a consequence of fluid shift into the damaged muscle a compartment syndrome may lead to vascular or neural defects. In 80% of cases there is initial hypocalcemia, turning later into hypercalcemia. Other frequent electrolyte disorders accompanying rhabdomyolysis are hyperkalemia, hyperphosphatemia and a widened anion gap. 6 of 13 patients showed the typical blood changes found in patients with disseminated intravascular coagulation. Acute renal failure developed in 30 patients, 15 of whom underwent dialysis or hemofiltration.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Acute rhabdomyolysis]. 395 76

We present the case of a 35-year-old man who developed symptoms of the neuroleptic malignant syndrome (NMS) after taking prescribed, moderately high, therapeutic doses of haloperidol. When brought to the emergency department, he was comatose, hypotensive, and had rigid muscle tone and a core body temperature of 42.2 C. Although initial treatment was supportive, intubation, ventilator support, and further care in the intensive care unit were necessary. Ensuing disseminated intravascular coagulation was treated successfully and the patient was weaned from the ventilator on the third day after admission. He was discharged from the hospital 11 days after admission. Recently recognized drug therapy for NMS, such as bromocriptine mesylate and dantrolene sodium, was not used in this case.
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PMID:Neuroleptic malignant syndrome. 398 49


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