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)

Twenty cases of toxic epidermal necrolysis were studied. 14 male and 6 female. The peak incidence by age was in the first two decades. All of them were related to drugs. Twelve of the cases had received antibiotics and, therefore an infection existed. The remaining 8 cases did not receive antibiotics and had no concomitant infection. We emphasise the clinical observation that in 11 cases the first symptom was an increase in cutaneous sensitivity, and then a rise in temperature, malaise, and extensive cutaneous sloughing resembling extensive burns. As for complications, only in 4 patients could we demonstrate disseminated intravascular coagulation (haematological tests were carried out in only 14 patients). The commonest complication observed was glomerular nephritis. Blood counts, blood chemistry and urine tests were altered more in relation to complications than to TEN. Protein electrophoresis, conversely, showed an increase of gamma globulin in 53.3% of cases, and inverted A/G ratio in 80%. S. aureus was cultured in 12 cases (not all of them children). E.S.R. was increased in 18 cases. Pathological findings with those already described: "in toto" epidermal necrolysis, intra and subepidermal blisters, and occasional inflamatory reaction at the level of the papillae, and the non-uniform presence of melanin in basal cells and Lyell cells. Prognosis was excellent, since we only had one death and one case of blindness due to bilateral ocular perforation. This could be due to the general medical care of the patient, nursing them with D.I.C., which in certain cases substituted by heparin with excellent results. Antibiotics were used in those infected.
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PMID:[Toxic epidermal necrosis. Review of the theme and presentation of 20 cases]. 39 34

Evidence of disseminated intravascular coagulation was recorded in eight patients with toxic epidermal necrolysis (TEN)--Lyell's syndrome. Patients were treated with low doses of heparin in combination with the usual treatment of TEN, i.e. maintenance of fluid and electrolyte balance, systemic corticosteroids, antibiotics and aseptic dressings, in the Intensive Care Unit environment. It is suggested that the alteration of haemostasis and inter-related biological systems, such as activation of components of complement, kinins and immunoglobulins, may affect the outcome of TEN.
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PMID:Disseminated intravascular coagulation associated with toxic epidermal necrolysis (Lyell's syndrome). 44 27

Acute toxic epidermal necrolysis (Lyell's syndrome) ended fatally in a 48-year-old patient with chronic recurrent bronchial pneumonia. A marked haemorrhagic diathesis had developed, with signs of severe clotting and platelet abnormalities, indicating that the clotting disorder was, in the first instance, the result of "toxic" liver and bone-marrow damage (in connection with the recurrent pneumonia and its previous drug treatment), and not disseminated intravascular coagulation. The clotting abnormalities in this patient were probably less the result of "necrolysis" of the epidermis than an accompanying effect of the generatized intoxication of multiple aetiologies of the entire organism, which probably also precipitated the fulminating course of the Lyell's syndrome. An important part, of course, was the preceding protracted administration of chloramphenicol for the recurrent bronchial pneumonia.
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PMID:[Clotting abnormalities in the Lyell's syndrome (acute toxic epidermal necrolysis) (author's transl)]. 118 36

Toxic epidermal necrolysis represents an immunologic reaction to a foreign antigen and is most often caused by drugs. Atorvastatin, a blood cholesterol-lowering agent, is a recognized cause of rhabdomyolysis; while naproxen, a widely used nonsteroidal anti-inflammatory drug, is a known cause of photo-induced skin lesions. We report the first fatal case of drug-induced toxic epidermal necrolysis associated with severe muscle necrosis due to the use of a nonsteroidal anti-inflammatory drug and a statin with very high levels of creatine phosphokinase leading to acute kidney injury, disseminated intravascular coagulation, and complete skin necrosis leading to death.
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PMID:A fatal case of cutaneous adverse drug-induced toxic epidermal necrolysis associated with severe rhabdomyolysis. 2258 45

We report a case of asplenic fulminant sepsis in Australia following a dog bite which was complicated by toxic epidermal necrolysis/Stevens-Johnson syndrome (TENS/SJS). Capnocytophaga canimorsus, the infective organism, is a rare cause of septicaemia: a high degree of suspicion of this unusual organism and its early aggressive management is paramount. The diagnostic and management difficulties of TENS/SJS in the context of a patient with fulminant sepsis, DIC and on inotropes are also highlighted.
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PMID:Asplenic fulminant sepsis secondary to a dog bite complicated by toxic epidermal necrolysis/Stevens-Johnson syndrome. 2286 59