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Target Concepts:
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Query: UMLS:C0012739 (
disseminated intravascular coagulation
)
8,673
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
A 54-year-old man received insertion of an acupuncture needle into the region extending from the posterior neck to the back on two occasions for the treatment of shoulder stiffness. Two weeks after the second acupuncture, he developed fever, dysarthria and mictionary disturbance, finally reaching the condition of tetraplegia. He was immediately admitted to an emergency room in our hospital, and was diagnosed as sepsis with
DIC
, ARDS, heart failure, renal failure, liver failure, and myelitis. After one month, he recovered with transverse myelopathy as a residual deficit. Neurological findings showed transverse myelopathy below the level of Th2 at that time. Cervical CT revealed an irregular low density at the periphery of the cervical vertebra from the C2 to C4 level. Cervical MRI revealed an irregular swelling of his spinal cord from the C2 to C7 level. We explained the mechanism of transverse myelopathy in this case as follows. After the acupuncture, he suffered a
focal infection
of the region of needle insertion, and then the infection expanded to the cervical vertebra, thus causing osteomyelitis, sepsis, and finally cervical myelitis. Direct injury of the spinal cord and nerve roots as a complication of acupuncture was previously reported, but indirect injury of the spinal cord due to myelitis had not been reported except our present case. Careful attentions should be paid to the complications of acupuncture.
...
PMID:[A case of transverse myelopathy caused by acupuncture]. 178 54
As the development of a hypercoagulable state in the setting of
disseminated intravascular coagulation
(
DIC
) induces
localized infection
, therapy for
DIC
should be evaluated according to the findings of examinations for both severe sepsis and
DIC
.
DIC
is classified into the following types: "bleeding type," "organ failure type," "asymptomatic type," and "complication type." The "bleeding type" and "organ failure type" are considered to reflect the "plasmin inhibitor (PI) deficiency type" and "antithrombin (AT) deficiency type," respectively. In order to improve the diagnosis of
DIC
, in particular limitations in global coagulation tests, the Japanese Society of Thrombosis and Hemostasis recently proposed tentative diagnostic criteria for
DIC
using hemostatic molecular markers and AT. The recommendations for treatment of
DIC
, especially the use of AT concentrates, recombinant activated protein C and thrombomodulin, vary among several guidelines for the management of
DIC
. These agents inhibit the effects of key proteases in activating coagulation and consequently exert an anti-inflammatory effect on
DIC
. Hence, it is necessary to extensively evaluate these agents in well-conducted clinical trials.
...
PMID:[Progress in diagnosis and treatment for disseminated intravascular coagulation]. 2576 97