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

This report of 8 cases (6 severe and 2 mild) heat stroke patients seen during the hot summer of 1987 at Pramongkutklao Hospital, Bangkok, represent the first report of this syndrome in Thailand. Severe cases presented with deep coma, shock, ARDS, DIC and other systemic complications. Two cases of mild heat stroke recovered completely with conventional treatment. Two of the 6 severe cases died with DIC, bleeding and acute renal failure. The other 4 surviving cases received early exchange transfusion and low dose heparin therapy. The clinical features of these 4 cases were as severe as those recorded for fatal heat stroke patients, including shock over 10 hours in 4, coma longer than 120 hours in 3, ARDS and DIC in 1. From these findings, early exchange transfusion plus low dose heparin should be considered as one effective treatment in severe fatal heat stroke patients.
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PMID:Clinical manifestations and therapy of heat stroke: consumptive coagulopathy successfully treated by exchange transfusion and heparin. 263 55

A 38-year old quintipara with an unremarkable medical history suddenly complained of nausea during delivery, became pulseless and cyanotic, and lost consciousness. The ECG showed evidence of tachycardia, ventricular extrasystoles, and right-ventricular strain. Within 30 min there were also hemorrhage and a consumption coagulopathy (Table 1). Kerato-hyaline cell material was found in central-venous blood. Following cardiopulmonary resuscitation, emergency cesarean section, hemotherapy (Table 2), and intensive care (acute renal failure, ARDS, sepsis) the patient was able to be released with no permanent sequelae. The etiology, epidemiology, and clinical aspects of amniotic fluid embolism are discussed.
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PMID:[Amniotic fluid embolism]. 264 92

Acute renal failure complicates the course in 5% to 30% of victims of severe viper poisoning. No consensus exists on the single mechanism causing acute renal failure after viper bite. It is known, however, that viper venom induces several clinical abnormalities that favor the development of acute renal failure. These alterations include a varying degree of bleeding, hypotension, circulatory collapse, intravascular hemolysis, and disseminated intravascular coagulation with or without microangiopathy. A direct cytotoxic action of snake venom on the kidney is suspected, but convincing evidence is still lacking. Severe hypocomplementemia is consistently present, but I doubt its role in the causation of renal lesions. Hypersensitivity to venomous or antivenomous protein occasionally causes acute renal failure. In sea snake poisoning, myonecrosis and myoglobinuria appear to play the predominant pathogenetic role. The renal lesions of clinical significance in envenomed patients are acute tubular and patchy or diffuse cortical necrosis. Glomerulonephritis, interstitial nephritis, and papillary necrosis have been reported in rare patients. I trust that this overview of the clinical and basic-science aspects of snake-bite-induced acute renal failure will prompt investigators to further define the pathogenetic mechanisms involved. Lessons learned may aid patients with acute renal failure of diverse causes, both here in India and around the world.
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PMID:Snake-bite-induced acute renal failure in India. 265 63

A case of emphysematous pyelonephritis with septic shock was present in a 58-year-old diabetic woman. The spontaneous production of gas was present within the right renal pelvis in kidney-ureter-bladder X-ray. The patient's condition deteriorated rapidly after admission, became complicated with acute renal failure, disseminated intravascular coagulation and acute respiratory failure. Transurethral drainage of the pelvis using a 6 Fr. UPJ occlusion balloon catheter and endotracheal intubation with respiratory assistance were performed as a life-saving procedure. The optimal therapy with surgical or conservative approach for such a severe condition is discussed. The use of transurethral drainage of pelvis as a non-invasive treatment is suggested.
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PMID:[A case of emphysematous pyelonephritis with septic shock recovered by transurethral drainage of pelvis]. 267 63

The paper is concerned with four Marathon athletes who developed grave impairments in hemodynamics and microcirculatory disorders in the organs (collapse, acute renal failure, cerebral abnormalities) and signs of the grave acute syndrome of disseminated intravascular coagulation with thrombohemorrhage and bleeding after competitions carried out under unfavourable conditions (a temperature of 30 degrees C and high air humidity). Three patients died. The diagnosis of the syndrome of disseminated intravascular coagulation was supported at autopsy. One of the athletes suffered brain stroke. The clinical and laboratory examination of the other 19 Marathon athletes showed that after competitions 6 persons had subclinical hemostatic disorders characteristic of the syndrome of disseminated intravascular coagulation. It is recommended that control and correction of hemostatic disorders should be strictly exercised in athletes experiencing hard and prolonged physical exercise.
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PMID:[The syndrome of disseminated intravascular coagulation in marathon athletes]. 271 33

The case is presented of a 36-year-old secundipara with the uterine myoma and a mild form of EPH gestosis. She became icteric and anuric on the sixth day after a spontaneous vaginal delivery and an apparently uneventful early puerperium. Blood coagulation tests were characteristic of disseminated intravascular coagulation (DIC). Since it is postulated that the appearance of DIC could be connected with the probable necrosis of a preexisting uterine myoma, abdominal hysterectomy was performed on the 8th puerperal day. Because of a persisting acute renal failure with highly elevated BUN levels and creatinine, the patient was subjected to haemodialysis every day during the next 73 days. After 3 months of this treatment she was discharged from hospital with a reduced but satisfactory renal function. The pathogenesis of DIC and acute renal failure following necrosis of the uterine myoma is discussed.
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PMID:[Acute renal failure following necrosis of a myoma in the puerperium]. 273 39

The clinical course of ten cases of head injury complicated with multiple systemic injuries were studied by comparing two groups divided according to the presence or absence of associated coagulative-fibrinolytic abnormality. All these cases had intracranial hemorrhagic lesions proven by the high density area in the initial CT scan. Five cases showed signs of disseminated intravascular coagulation (DIC) as evidenced by decreased counts of platelet, and/or elevated value of FDP at the time of admission. Four cases out of these five were in a state of hemorrhagic shock. All these five cases showed a subsequent enlargement of intracranial hematoma. Four cases died. Two of them, who had low initial Glasgow Coma Scale (G.C.S) died of uncontrollable increase of intracranial pressure. The other two, who had high initial G.C.S., died of acute renal failure and multiple organ failure. In contrast with these cases, five cases without signs of DIC intracranial hematomas did not enlarge in spite of the similar neurological conditions to the former group. In head injured patients with systemic injury, DIC frequently causes secondary hemorrhage in the intracranial lesions of minor severity.
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PMID:[Enlarging of intracranial hemorrhagic lesions and coagulative-fibrinolytic abnormalities in multiple-injury patients]. 277 Sep 70

Exertion-induced heat stroke is a relatively rare disorder in the moderate maritime climate of The Netherlands. Serious complications of excessive physical activity rarely occur. We describe a marathon runner with multi-organ failure after exertion-induced heat stroke. The patient developed shock, diarrhoea, coma, rhabdomyolysis, acute renal failure, liver cell damage and disseminated intravascular coagulation but recovered completely.
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PMID:Multi-organ damage in exertional heat stroke. 277 93

From 1958 to 1987, 81 cases of pregnancy-related acute renal failure (PR-ARF) were observed (9% of the total number of acute renal failure [ARF] needing dialysis). In the three successive ten-year periods (1958-67, 1968-77, 1978-87) the incidence of PR-ARF fell from 43% to 2.8% with respect to the total number of ARF, and from 1/3,000 to 1/15,000 with respect to the total number of pregnancies. Maternal mortality was high (32%), with 5 cases of death in the last ten years. Irreversible renal damage was recorded in 11.6% of PR-ARF, and, in particular, in 26.3% of cases in preeclampsia-eclampsia (PE-E). Worse maternal and renal prognosis occurred in PE-E complicated by abruptio placentae. Neither disseminated intravascular coagulation (DIC), microangiopathic hemolytic anemia nor prostacyclin imbalance were significantly related to the severity of renal damage. Heparin therapy did not modify DIC evolution and renal outcome and was aggravated by severe hemorrhagic complications. In conclusion, PR-ARF has become a rare, but still critical occurrence, and the most effective measures would be a program of careful prevention.
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PMID:Pregnancy-related acute renal failure. 278 54

This is a case report of aortic dissection associated with percutaneous intraaortic balloon insertion, which was attempted for systolic unloading after repair of left ventricular rupture. But the hemodynamic condition gradually deteriorated in spite of IABP support and aortic dissection was suspected from the difference between monitoring pressures of bilateral radial arteries and balloon tip. The balloon was removed on the 3rd postoperative day, but the patient died from renal failure, liver dysfunction and D.I.C. on the 7th postoperative day. At postmortem examination, aortic dissection was found, which extended from left common iliac artery, all the way past right renal artery and ended just below origin of left subclavian artery. Therefore, acute renal failure was supposed to be followed by aortic dissection.
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PMID:[Aortic dissection associated with percutaneous intra-aortic balloon pumping]. 279 98


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