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)

Levels of serum fibrin degradation products (FDP) were determined in patients with acute nephritis, chronic nephritis, lupus nephritis and toxemia of pregnancy by the passive hemagglutination inhibition test. Serum FDP levels were less than 10 mug/ml in normal control adults, averaging 3.2 +/- 1.2 mug/ml. The incidence of serum FDP positive patients (more than 10 mug/ml) in those with acute nephritis, chronic nephritis, lupus nephritis and toxemia of pregnancy was 28%, 73%, 100% and 100%, respectively. Their serum FDP levels averaged 8.4 +/- 5.6 mug/ml, 16.0 +/- 5.9 mug/ml, 21.4 +/- 7.6 mug/ml and 35 mug/ml, respectively. Plasma fibrinogen levels, prothrombin time, partial thromboplastin time, euglobulin lysis time and platelet counts were within normal limits in serum FDP positive patients with renal diseases, indicating that there was no severe disseminated intravascular coagulation. All FDP positive patients with renal diseases of immunological origin demonstrated the deposition of fibrin within glomeruli with complement and immunoglobulin deposits. However, FDP positive patients with toxemia of pregnancy demonstrated fibrin depositions within glomeruli without complement and immunoglobulin deposits. FDP D fragments of urine from lupus nephritis patients showed no changes in immunoelectrophoretic patterns by heat treatment, indicating that urine FDP was derived from secondary fibrinolysis.
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PMID:Fibrin degradation products in renal diseases. 78 95

A radioimmunoassay for fibrinopeptide A (FPA) has been developed. This assay uses rabbit antibodies induced by injection of native FPA-human serum albumin conjugates and 125I introduced into tyrosine-FPA synthesized in out laboratory. Plasma FPA is separated from fibrinogen by TCA extraction. The assay is capable of detecting as little as 50 pg/ml of FPA. In 20 normal donors this assay revealed a mean concentration of 0.9 ng/ml (0.3 SD). In five patients with disseminated intravascular coagulation, FPA concentrations ranged from 13.0 to 346 ng/ml. Two groups of patients with systemic lupus erythematosus (SLE) whose disease had achieved complete remission were studied; one consisted of four patients with no history of lupus nephritis and another with a history of nephritis. Mean FPA concentrations of 1.5 ng/ml (range, 0.7-1.8 ng/ml) and 2.7 ng/ml (range, 1.1-5.6 ng/ml) were found in these two groups, respectively. Another group of nine patients with active SLE, but without evidence of lupus nephritis, had a mean FPA concentration of 4.5 ng/ml (range, 2.4-7.8 ng/ml). Finally, a group of seven patients with active SLE, including active nephritis, had a mean FPA concentration of 10.2 ng/ml (range, 5.3-17.0 ng/ml). A positive correlation was found between the concentration of plasma FPA and serum DNA-binding activity and an inverse correlation was found between plasma FPA and the concentration of serum C3. No correlation existed between plasma FPA and concentration of serum creatinine. Several possibilities for the origin of plasma FPA in patients with SLE were considered; at present it seems most likely that FPA arises through the action of thrombin on fibrinogen.
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PMID:Fibrinopeptide A in plasma of normal subjects and patients with disseminated intravascular coagulation and systemic lupus erythematosus. 93 2

Immune complex inflammation associated with systemic lupus erythematosus (SLE) is attended by activation of the coagulation system up to the development of disseminated intravascular blood coagulation (the DIC syndrome). Study of the hemocoagulation in 106 patients with SLE revealed the signs of the chronic DIC syndrome that manifested itself largely by hypercoagulation, increased thrombin formation and proneness to inhibition or activation of fibrinolysis. These alterations were more demonstrable in patients with a highly active condition and lupus nephritis. The clinical symptoms of the chronic DIC syndrome in the form of hemorrhages and thromboses were seen in 27 patients. Correlations were discovered between the level of soluble fibrin-monomer complexes and characteristics of inflammatory and immunologic activity. Therefore, a close interrelationship has been shown between immune complex processes and alterations in the hemocoagulation associated with SLE. It has been also demonstrated that the DIC syndrome plays a role in the progression of lupus nephritis.
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PMID:[Intravascular blood coagulation and immune complex inflammation in patients with systemic lupus erythematosus]. 293 51

We describe 26 pregnancies in 19 patients with lupus nephritis. There were 4 spontaneous abortions, 2 therapeutic abortions, 4 stillbirths and 1 neonatal death. 10 deliveries were preterm and 2 fetuses were small for gestational age. 8 pregnancies were not accompanied by change of renal symptoms. Mild signs of renal involvement appeared during pregnancy in 4 patients. 6 patients showed an increase in proteinuria already present before pregnancy without renal function deterioration. A moderate worsening of renal function was observed in 3 patients. 4 patients, 3 of whom had an apparent onset of systemic lupus erythematosus during pregnancy, developed anuric acute renal failure after delivery or after late spontaneous abortion. 2 of them died from sepsis and disseminated intravascular coagulation while 2 had complete recovery of renal function. A high rate of complications was observed in patients not adequately treated during pregnancy. Renal biopsy before gestation was not predictive of the outcome of nephropathy during pregnancy, and change of histology in repeated biopsies was frequently observed.
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PMID:Lupus nephropathy and pregnancy. A study of 26 pregnancies in patients with systemic lupus erythematosus and nephritis. 669 Oct 1

Glomerular thrombi occur frequently in active lupus nephritis. Their presence has been correlated with low platelet counts and with subsequent development of glomerular sclerosis. We have examined the plasma PGI2 generating capacity of 8 patients with active lupus nephritis with thrombi that were to undergo defibrination therapy with ancrod. PGI2 generation by these plasma samples was significantly decreased as compared both to normals and to 6 individuals with lupus nephritis and no glomerular thrombi. Significant improvement in the capacity to generate PGI2 was seen in the post-ancrod treatment plasma samples. the pathogenesis of this defect is discussed.
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PMID:Deficiency of a plasma factor stimulating vascular prostacyclin generation in patients with lupus nephritis and glomerular thrombi and its correction by ancrod: in-vivo and in-vitro observations. 675 85

We investigated the intraglomerular distribution of thrombomodulin (TM) antigen in patients with various renal diseases. The subjects enrolled in this study were 28 patients with IgA nephropathy, 26 with collagen diseases, 10 with toxemia and 4 with DIC. Normal renal cortex used as a control was obtained from the normal pole of kidneys with a tumor of the opposite pole. Intraglomerular distribution of TM antigen was detected by an immunohistochemical method using a polyclonal antibody against human TM. The following results were obtained: 1) The staining intensity of TM on endothelial cells of glomerular tufts was higher in IgA nephropathy and collagen diseases than in the controls, but was the same in toxemia and DIC as in the controls. 2) The staining intensity of TM decreased with the progression of the glomerular lesion in IgA nephropathy and lupus nephritis. These findings suggest that the intraglomerular distribution of TM may be involved in the progression of glomerular lesions and in the acceleration of intraglomerular blood coagulation in various renal diseases.
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PMID:[Intraglomerular distribution of thrombomodulin in patients with various renal diseases]. 796 73

A 41-year-old woman with complete protein S (PS) deficiency who developed diffuse proliferative lupus nephritis is reported. She was referred to our hospital with nephrotic syndrome and thrombocytopenia. Her medical history included colorectostomy and amputation of the extremities because of repeated thrombotic episodes during her teens without any evidence of systemic lupus erythematosus. The diagnosis of PS deficiency was made from the patient's clinical course, undetectable serum PS in either the active or inactive form, normal protein C activity, and no evidence of the antiphospholipid syndrome. However, there was no definitive family history. A depressed level of complements and a positive antinuclear acid antibody suggested a diagnosis of systemic lupus erythematosus. The patient had a rapidly progressive course and died of disseminated intravascular coagulation. An autopsy showed generalized thrombotic lesions and diffuse proliferative lupus nephritis on both ordinal light and immunoperoxidase microscopy. Our observations suggest that PS-deficient patients may have a hyperinflammatory response.
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PMID:A 41-year-old woman with protein S deficiency and diffuse proliferative lupus nephritis: is protein S deficiency associated with a hyperinflammatory response? 918 80

Herein we describe a case of a patient with elderly-onset systemic lupus erythematosus presenting as acute renal failure due to disseminated intravascular coagulation. A 78-year-old man was admitted to our hospital with fever and generalized lymphadenopathy. He was diagnosed as having systemic lupus erythematosus on the basis of renal involvement, hematological abnormality and positivity for antinuclear and anti-double-stranded DNA antibodies. Renal biopsy revealed lupus nephritis (class III and V (A/C)) with focal glomerular thrombosis. He responded to hemodialysis and corticosteroid therapy with remission of serological values and renal function. Possible mechanisms underlying the coexistence of these conditions are discussed.
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PMID:A case of elderly-onset systemic lupus erythematosus presenting as acute renal failure due to disseminated intravascular coagulation. 1624 Sep 1

We retrospectively evaluated the clinico-laboratory features of 11 children and adolescents with Systemic Lupus Erythematosus between the period of 2001 and 2006. All of them (100.0%) had renal involvement at the first visit in the hospital. Female to male ratio was 10:1. Skin and or mucosal involvement (90.9%), periorbital puffiness and or pedal edema (81.8%), fever (72.7%), hypertension (72.7%), and reticuloendothelial involvement (72.7%), were the commonest presentations. All patients had anemia (8.6 +/- 1.5 gm/dl), raised ESR (46.7 +/- 9.4 mm in first hour), proteinuria, and in disease activity as evident by raised ESR and positive anti-dsDNA antibody at the first visit. The mean duration of disease was 7.6 months and the average duration of disease activity was 63.18 days. Renal biopsy was performed in 8 patients: class IV lupus nephritis in 4 patients (50.0%), class II in 2 patients (25.0%), class III and V in patient (12.5%) each. Nephrotic range proteinuria and hypertension was observed in all patients of class IV and V of lupus nephritis. Class II and III lupus nephritis patients' were normotensive and had non-nephrotic range proteinuria. Three out of 11 patients (27.2%) expired. The commonest primary determinant of mortality was uncontrolled disease activity in 2 patients (66.6%). The third one had infection and developed disseminated intravascular coagulation. The mean duration of disease activity in patients who died (mean 30 days) was statistically lower than the survival group (75.6 days) (p < 0.01). Renal involvement during first visit and mortality could be attributed by late referrals and diagnosis at hospital.
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PMID:Systemic lupus erythematosus in childhood--a review of 11 patients at a single center in eastern Nepal. 1809 38