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)

Serious hepatotoxicity is uncommon with the proper therapeutic use of non-narcotic analgesics but experience with new non-steroidal anti-inflammatory drugs (NSAIDs) is limited. Drugs such as ibufenac, fenclofenac and benoxaprofen were withdrawn from the market because of hepatotoxicity, and liver damage has been reported on occasion with virtually all non-narcotic analgesics. However, a clear pattern of toxicity with characteristic clinical, biochemical and histopathological abnormalities has emerged with relatively few. With the exception of acute hepatic necrosis following overdosage of paracetamol, little is known of the mechanisms of liver injury induced by non-narcotic analgesics. Involvement of the liver in a generalised drug reaction does not imply specific hepatotoxicity. About 50% of patients given aspirin regularly in anti-inflammatory doses develop mild, dose-dependent reversible liver damage as shown by elevation of the plasma aminotransferase activity. Liver damage is more severe in a small minority and it may rarely be complicated by disseminated intravascular coagulation and encephalopathy with a fatal outcome. There have also been isolated reports of chronic active hepatitis associated with the use of salicylates. Salicylate hepatitis has been reported most often in young females with connective tissue diseases. Many patients with Reye's syndrome have been given aspirin during the prodromal phase, and this serious condition closely resembles subacute salicylate intoxication in children. Salicylate probably has a causal or contributory role in Reye's syndrome, but many refuse to accept this and the issue is the subject of heated debate. Paracetamol in overdosage causes acute hepatic necrosis, and liver damage has been attributed to its therapeutic use. However, most reports have involved chronic alcoholics who took excessive doses and in these patients the clinical, biochemical and pathological findings were typical of paracetamol overdosage. Many authors have failed to make the distinction between therapeutic use and a therapeutic dose. In other cases liver damage could have been caused by exposure to other agents, viral infection or naturally occurring liver disease. If these cases are excluded, there are very few reports of liver damage associated with the proper therapeutic use of paracetamol. In some cases, the picture resembled chronic active hepatitis but no causal relationship has been established between this condition and paracetamol use. Paracetamol does not cause deterioration in liver function in patients with chronic liver disease.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Effects of non-narcotic analgesics on the liver. 355 80

Herpes simplex viral (HSV) hepatitis is uncommon in adults. Two new cases are reported herein; a literature review revealed an additional 33 patients. Ages ranged from 13 to 87 years; the mean age was 32.6 years, and the median was 28 years. HSV hepatitis usually occurs as part of disseminated HSV infection and is characterized by fulminant hepatic necrosis with serum transaminase levels frequently elevated 100- to 1,000-fold. Disseminated intravascular coagulation was present in 90% of the cases. Outcome was poor; 86% of the patients died. Eighty-six percent of the patients had an underlying condition associated with impaired host defenses. Renal transplantation (26%), steroid use other than in renal transplant patients (26%), and pregnancy (23%) were the most frequent underlying conditions. Early recognition and prompt initiation of antiviral therapy may offer a chance for improved survival rates.
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PMID:Herpes simplex viral hepatitis in adults: two case reports and review of the literature. 358 33

A clinicopathological study was undertaken in 15 cases of massive hepatic necrosis after shock. The GOT and GPT level exceeded 1000 units in 10 cases. The 15 cases consisted of 3 diagnosed as fulminant hepatitis clinically and 12 diagnosed as disseminated intravascular coagulation (DIC) or multiple systemic organ failure (MOF) from the unremarkableness of liver dysfunction. It was noteworthy that sepsis and surgery were closely associated with these lesions. The weight of the liver at autopsy ranged from 800 to 2,700 g. Liver necrosis was macroscopically characterized by clear demarcation of the necrotic areas sharply separated from the surrounding liver parenchyma, showing the appearance of so-called "map-like necrosis". Microscopically, the lesions in these subjects showed mainly the pattern of centrilobular necrosis. As observed in the burn shock case (case 12), the shock which provoked in different phases of time seemed to have repeated its attack. These liver necroses were considered to result from severe systemic circulatory disturbance or intrahepatic circulatory disturbance. The possibility is indicated that the generalized or univisceral Shwartzman reaction, and repeated and combined severe shock participated in the pathogenesis. Fibrin thrombi aggrevate tissue perfusion and accelerate anoxia. Heparin therapy seemed effective in these cases if administered at an appropriate time.
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PMID:Fatal hepatic necrosis after shock. 371 91

From January 1982 through December 1983, 83 severely injured and hypovolemic patients were immediately resuscitated with uncrossmatched packed red cells. Seventy-four patients received 250 units (3.3 units/pt) of Group O red blood cells (TOB), and nine patients received 27 units of type-specific blood (TSB) (3.0 units/pt). Additionally, 53 units of TSB were transfused to the TOB group in the interval between TOB immediate transfusion and the availability of fully crossmatched blood. A total of 880 units (10.6 units/pt) were transfused without instance of transfusion reaction or subsequent crossmatching difficulty. The protocol called for two units of TOB (Rh positive for males, Rh negative for females) to be delivered to the resuscitation area before patient arrival. The decision to transfuse TOB was left to the surgeon in charge and was based on the clinical impression of severe shock. Thirty-eight per cent (31 patients) met the criteria of requiring a 'massive transfusion' (greater than 10 units within 24 hours). Overall, 28 patients (31%) died, 22 within hours of arrival. No death was attributable to transfusion reaction or blood incompatibility. Complications included one dysrhythmia, six patients developed ARDS (7.2%), and ten patients (12%) had 'DIC'. Two patients developed positive hepatitis screens, and there was one clinical case of hepatitis observed. None of the 'DIC' cases were related to incompatible blood transfusion. We conclude that for immediate trauma resuscitation, TOB is safe and TOB has additional advantages over TSB or Type O whole blood transfusion.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Immediate trauma resuscitation with type O uncrossmatched blood: a two-year prospective experience. 377 97

Despite an excellent military experience with the use of the "universal donor" as an immediately available blood component, considerable reluctance to use uncrossmatched Group O packed cells (TOB) remains. In addition, problems continue with rapid blood acquisition in the emergency department. To study the safety of TOB used as an immediate resuscitation component, a 30-month prospective study of all patients arriving at a single trauma unit was undertaken. By protocol TOB (O-, female; O+, male) was delivered to the shock room prior to patient arrival and was expanded to 500 mL by adding 250 mL prewarmed saline (39.4 C) to the existing RBC unit. Transfusion was ordered on clinical signs of Class III or Class IV hemorrhage. Ninety-nine patients entered the protocol, receiving a total of 1,136 units of blood (11.5 units/patient). Four hundred ten units (4.1 units/patient) of uncrossmatched blood were administered on patient arrival--322 units of TOB and 88 units of type-specific blood (TSB). Seven patients (7.4%) had prior transfusions, and 14 (58%) women had prior pregnancies. Complications included disseminated intravascular coagulation, 12%; adult respiratory distress syndrome, 8%; and hepatitis, 1%. Forty-nine patients (49%) required massive transfusion (greater than 10 units/24 hr). All patients were followed clinically and by the blood bank for any signs of transfusion reactions or incompatibility throughout their hospital courses; none developed. There were no deaths related to transfusion incompatibility. We conclude that TOB used as an immediate resuscitative blood component is safe.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Saline-expanded group O uncrossmatched packed red blood cells as an initial resuscitation fluid in severe shock. 377 83

A comparative study of two patients, one affected by haemorrhagic shock and encephalopathy (HSE) and the other by heatstroke is reported. Both presented shock, disseminated intravascular coagulation, neurological damage and hepatopathy. A lowered alpha 1-antitrypsin concentration as well as a slightly increased circulating immune complexes and complement consumption were observed in the HSE patient but not in the heatstroke one. In both, cultures for bacteria were negative, the viral serology was non-specific and hepatitis A and B studies were negative. HSE patient died. A possible relationship between HSE, heatstroke, malignant hyperthermia and halothane hepatitis is postulated. Fever, potentially hepatotoxic drugs or unknown agents (HSE) might trigger this clinical picture.
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PMID:[Hemorrhagic shock and encephalopathy. Its possible relation with heat stroke]. 407 88

The authors report three cases of jaundice which developed during pregnancy and which rapidly resulted in the death of the patients. One case was a fulminant case of cytomegalovirus hepatitis and the other two were cases of acute steatosis of pregnancy. The clinical features are marked by the rapid development of a neurological syndrome resulting in coma and the association of blood dyscrasias due to major hepato-cellular failure resulting in DIC. The rapid progression of the disease generally results in the death of the mother and the child. However, there are some reports of survival with total cure after rapid extraction of the foetus, which justify an active therapeutic attitude.
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PMID:[Severe jaundice with fatal outcome in pregnancy]. 609 54

It is essential for an efficient substitution to define the nature of the defect as good as possible. Simple screening tests allow a rapid classification. Prophylactic substitution is recommended in potentially reversible defects (bone marrow aplasia in connection with leukaemia treatment) and/or imminent bleeding (eventually complicated by additional risk factors). If bleeding cannot be stopped surgically therapeutic substitution is indicated. In case of bone marrow failure, a substitution may be particularly promising. In presence of an increased peripheral platelet destruction (disseminated intravascular coagulation, antithrombocytic antibodies) treatment of the basic disease is mandatory. Combined hemostatic defects can be influenced by fresh frozen plasma (FFP). Fresh whole blood (not older than 48 hours) may be considered in cases of thrombocytopenia and concomitant anemia. For isolated defects (e.g. hemophilias with or without antibodies, congenital afibrinogenemia, lack of factor XIII) special preparations are at hand. The clinical effect of substitution depends on the specific activity of the preparation, on the volume of expansion in the recipient and on other pharmacokinetic factors. Hepatitis and antibody-production may be considered as particularly grave side-effects.
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PMID:[Controlled substitution with blood products in hemostatic disorders]. 618 45

This is a case report of a sarcomatous Wilms tumor complicating disseminated intravascular coagulation with gastrointestinal bleeding, ascites, pleural effusion, and hepatitis after the second course of actinomycin D. A sarcomatous Wilms tumor is believed to have an unfavorable prognosis even if multimodal therapy is given. Arteriovenous fistulae which we created for purposes of chemotherapy and hyperalimentation by microvascular-sleeve anastomosis functioned well for three years in spite of repeated punctures.
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PMID:Sarcomatous Wilms tumor associated with consumption coagulopathy. 630 72

A patient had disseminated herpes simplex, type 1, virus infection manifested by fulminant hepatitis and disseminated intravascular coagulation. The diagnosis was established by isolation of the virus from throat, urine, and buffy coat and confirmed at autopsy by the visualization of typical inclusions, demonstration of herpesvirus particles by electron microscopy, and specific immunoperoxidase staining. Therapy with vidarabine did not alter the fatal course. On the basis of clinical features and serologic results, the case represented a disseminated primary infection with herpes simplex, rather than reactivation of an endogenous infection, following renal transplantation.
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PMID:Primary disseminated herpes simplex infection with fulminant hepatitis following renal transplantation. 702 79


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