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)

Review of the coagulation laboratory records and medical records at Memorial Sloan-Kettering Cancer Center over a three year period (1971--1974) revealed 89 patients with disseminated intravascular coagulation (DIC). The diagnosis of DIC was made if laboratory studies showed evidence of quantitative and qualitative changes in fibrinogen and significant thrombocytopenia. The patients included 19 with leukemia (17 acute), 3 with multiple myeloma, 15 with lymphoma, 46 with metastatic solid tumors, (10 lung, 9 breast, 8 gastrointestinal, 12 genitourinary, 7 miscellaneous) 4 with vascular tumors, and 3 without tumor. Other conditions which might have precipitated or initiated DIC such as gram-negative sepsis, liver impairment, or mucin secreting tumors were present in the majority of patients. Bleeding occurred in 75% of the patients and was fatal in 36%. Thromboembolism occurred in 22.5%. Thirteen percent were asymptomatic. Serum lactic dehydrogenase was elevated in over 75% of the patients at the time of, or subsequent to the occurrence of DIC. Treatment with heparin was helpful in only three of twenty patients. Eighty percent of the patients died within one to over 30 days of the onset of DIC. Post mortem evidence of DIC was present in 18 of 43 autopsies. Results of this study indicate that DIC is a frequent complication of a wide variety of tumors and that its occurrence causes morbidity and mortality in a significant number of patients. Treatment with heparin is of little help unless remission is induced and the precipitating factor(s) are reversed.
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PMID:Disseminated intravascular coagulation: experience in a major cancer center. 17 94

Ten patients with severe hematologic malignancies (four with acute leukemia, three with multiple myeloma, one with prolymphocytic leukemia, one with malignant lymphoma and one with blastic crisis of chronic myelogenous leukemia) developed respiratory failure during the period between April 1986 and May 1990. Clinically, the patients manifested high-fever, dyspnea refractory to oxygen therapy, diffuse pulmonary rales and severe hypoxemia without evidence of cardiogenic pulmonary edema. Chest roentgenograms displayed diffuse alveolar infiltrates. Respiratory failure occurred as early as 48 hours and as late as 66 days after the administration of intensive anti-neoplastic chemotherapy. At that time leukocyte count was between 100/microliters and 54,900/microliters. Marked leukocytosis was observed in two patients with AML and PLL. Respiratory failure was preceded by sepsis in one patient with AML and by pneumonia in nine patients. DIC was diagnosed in four patients. All patients treated with high dose methyl prednisolone (mPSL) within 12 hours after the onset of respiratory failure. Only one patient required assisted ventilation. High dose mPSL had significant effect on seven of ten patients. But three patients died from progressive respiratory failure, sepsis, pneumonia and multi-organ failure.
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PMID:[Clinical investigation on acute respiratory failure in patients with severe hematologic malignancy]. 194 22

The retrospective study of acute renal failure (ARF) in patients with hematologic neoplasms was carried out. ARF occurred in 32 (6.1%) of 526 patients with hematologic neoplasms. Twenty-one (66%) patients recovered from ARF, but only 7 (22%) survived and were discharged from the hospital and 25 (78%) died of ARF or other complications. In 17 patients with leukemia or malignant histiocytosis, sepsis and/or disseminated intravascular coagulation were the most common causes of ARF, and all 17 patients died. In 11 patients with multiple myeloma, ARF was always attributable to the underlying disease, and the clinical course improved with the initiation of blood purification therapy (hemodialysis, plasma exchange) and chemotherapy. Five patients in blast crisis of chronic myelogenous leukemia or non-Hodgkin's lymphoma developed ARF as a result of tumor lysis syndrome. In this group, renal function improved with hemodialysis but only 2 patients survived. Patients with oliguria had worse outcomes than those without oliguria. Survival appeared to depend not on renal function but on the underlying disease, the cause of ARF, and other complications. These findings suggest that, in patients with hematologic neoplasms complicated by ARF, early initiation of blood purification therapy will improve the prognosis.
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PMID:[Acute renal failure in patients with hematologic neoplasms]. 238 Oct 56

We describe an atypical case of IgG lambda multiple myeloma in a 28-year-old patient. He developed multiple cutaneous plasmacytomas, and the terminal event, leukemic conversion by phagocytic plasma cells and disseminated intravascular coagulation. Secretion of monoclonal immunoglobulin (IgG lambda) from myeloma cells was demonstrated by plaque-forming cell assay. Electron microscopy showed myeloma cells with well-developed rough endoplasmic reticulum and erythroid cells or platelets in intracytoplasmic vacuoles.
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PMID:Phagocytic multiple myeloma with disseminated intravascular coagulation. 250 1

It has been shown that epitopes reactive with one group of rabbit antibodies to human fibrinopeptide A (hFPA, A alpha 1-16) are included in its COOH-terminal region (A alpha 7-16). It was further established that Asp-7, Phe-8, and Arg-16 contribute to immunoreactivity and that intact fibrinogen and hFPA-containing fragments react poorly with such antibodies. The purpose of this investigation was to prepare a synthetic peptide corresponding to A alpha 7-16 and use it for generation of FPA-specific monoclonal antibodies (MoAbs). Such probes would allow for development of assays that could measure hFPA directly in plasma. In our approach, an ovalbumin-conjugate of the hFPA homologue served as immunogen. Mouse spleen cells were fused with the immunoglobulin nonsecretor myeloma (P3X63Ag8.653). A hybridoma (8C2-5) has been isolated that secretes an antibody (MoAb/8C2-5) with the following characteristics: (a) IgG1, kappa isotype; (b) equilibrium dissociation constant of 1.5 +/- 0.2 x 10(7) L/mol with the [125I]-labeled N-tyrosyl derivative of hFPA [( 125I] Tyr-hFPA) as ligand; (c) reacts with hFPA and dog FPA (dFPA) but not with the des Arg (A alpha 1-15) or shorter peptides; (d) does not react with intact fibrinogen or A alpha-chain of human or dog origin; (e) does not react with the elastase-generated hFPA-containing peptide A alpha 1-21. Enzyme-based immunoassays (EIAs) have been developed for measuring plasma hFPA levels in the range 3 x 10(-8) to 5 x 10(-7) mol/L. Since it has already been shown by a number of investigators that hFPA levels in patients with overt defibrination fall into this range, we propose that the MoAb/8C2-5-based assays may serve as useful clinical tools in screening patients at risk of thrombosis. The 8C2-5 antibody may also be helpful in studies dealing with congenital dysfibrinogenemias, particularly in identifying heterozygous propositi with amino acid substitutions at any position within the A alpha 7-16 region. Finally, due to its cross-reactivity with dFPA, assays using this antibody should also be valuable in the canine experimental thrombosis model studies.
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PMID:Use of a synthetic homologue of human fibrinopeptide A for production of a monoclonal antibody specific for the free peptide. 275 51

A case of cerebral astrocytoma associated with a systematic multiple myeloma is reported. A 76-year-old man was admitted to our hospital because of left hemiparesis. The CT scan revealed a cystic tumor at the right parietal lobe. A serum protein electrophoresis showed a monoclonal peak in the region of gamma-globulin, and examination of bone marrow revealed 15% of atypical plasma cells. After irradiation and chemotherapy, the patient suffered from DIC syndrome and died. Autopsy findings revealed a cerebral astrocytoma and bone marrow infiltration by myeloma cells in the sternum, vertebrae, costae, pelvis, and so on. So we finally diagnosed this case a cerebral astrocytoma with systematic multiple myeloma. In spite of the fact that systematic multiple myeloma is frequently accompanied with cancers at other sites (so called multiple primary cancers), the coexistence of a cerebral astrocytoma and systematic multiple myeloma is extremely rare. Complications of multiple myeloma with other tumors are reviewed.
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PMID:[An autopsy case of cerebral astrocytoma associated with multiple myeloma]. 279 75

A patient with multiple myeloma (IgG, k) associated with hypertetraploid chromosomal abnormality is reported. The patient was a 62-year-old female. She was admitted to our clinic in October 6, 1982 because of lumbago and a supraorbital subcutaneous tumor. Cellulose acetate membrane electrophoresis of her serum disclosed a M-protein in the gamma-globulin, and immunoelectrophoresis showed monoclonal IgG, k type. A marrow aspirate of her sternum contained 15% myeloma cells, some of which were large, while others were atypical. A chromosomal analysis of her bone marrow revealed 34 hypertetraploid cells of 35 metaphase cells. Chemotherapy was administered without success and she died of DIC and uremia on November 11, 1982. Histologically, pleomorphic myeloma cells that contained large cells with atypical nuclei proliferated in her bone marrow.
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PMID:[A case of multiple myeloma (IgG, k) associated with hypertetraploid chromosomal abnormality]. 312 34

The incidence, severity and prognostic value of thrombocytopenia were studied in 80 patients with myeloma in connection with the clinical stage of the disease and the reaction to the cytostatic treatment. The studies were carried out before the treatment and followed up in the course of the treatment to remission or absence of remission. The results established a progressing thrombocytopenia with the evolution of the disease. Severe thrombocytopenia was established only in stage III, being with an unfavourable prognosis as regards the therapeutic response. The pathogenetic mechanism of its origination are discussed--malignant process in bone marrow, renal insufficiency, advancement of DIC syndrome and toxic effect by the cytostatics administered.
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PMID:[Prognostic value of thrombocytopenia in myeloma]. 359 Jul 37

The incidence and forms of DIC-syndrome were studied in 80 patients with myeloma. A battery of hemostatic tests was used, allowing the diagnosis of both the chronic decompensated and compensated forms. The syndrome has been established in 29% of the non-treated patients and becomes more frequent with the advancing of the clinical stage of the disease. Several patients with a rather special clinical course are described. The treatment of the syndrome coincides with the treatment of the basic disease and the concomitant complications, and heparin was administered only in single cases. The pathogenetic mechanisms for advancing of DIC in myeloma are described, associated with the character and peculiarities of the basic disease.
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PMID:[Incidence and forms of the DIC syndrome in multiple myeloma]. 376 92

Hemostasis was studied in 55 patients with myeloma, grouped in three groups according to the clinical stage of the disease. Thrombocytic adhesion, aggregation, activity of TF3 and TF4, of antithrombin III, FMDC level, FDP titre and fibrinolysis test were determined on the background of the screening coagulation tests. The studies were carried out before the treatment and were followed up after the therapeutic response or in the absence of improvement. Thirty per cent of the patients had manifestations of hemorrhagic diathesis, and 5 per cent - thromboembolism. Essential hemostatic deviations were found: progressive thrombocytopenia and thrombopathia and DIC syndrome that correlate with the stage of the disease, being most severe among the stage III patients. The patients that responded to the treatment had a great part of the hemostatic disorders corrected, and in case of no effect from the treatment - the deviations persisted, intensified and in 5 of the patients were responsible for the fatal end. The pathogenesis of the hemostatic deviations is complex and is associated with the characteristics of the basic disease and the concomitant complications.
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PMID:[Proceedings of the 7th Congress of Internal Medicine]. 665 83


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