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)

The fibrin-fibrinogen degradation products (FDP) tests were studied in 18 patients having a history of illness associated with diving. FDP tests were performed prior to hyperbaric oxygen therapy (OHP). Eight patients were serious neurologic signs had positive FDP tests and required repetitive therapy. Six patients had negative FDP tests with local musculoskeletal complaints and all were asymptomatic following the first OHP treatment. Three patients were found to be suffering from other diseases. These three patients had normal levels of FDP. One patient treated at another facility 3 months earlier and having paraplegia had a positive FDP test. Serious decompression sickness with neurologic complaints appear to have some degree of disseminated intravascular coagulation (DIC) as reflected by the FDP tests. The FDP test appears to be a useful screening test that may be able to delineate therapy.
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PMID:Screening test for decompression sickness. 97 Nov 82

Positive blood cultures were found in 41 patients on the Spinal Cord Injury Service at the Milwaukee VAMC during the period of July, 1980 to December, 1985 giving an incidence of bacteremia of 1.3%. Mortality rate was 17%. Most common pathogens were E. Coli, Proteus mirabilis, Serratia marcescens and Staphylococcus aureus. A review of 29 available charts revealed genitourinary and respiratory tracts as the most common sources of infection (72.4% and 10.3% respectively). Other sources of infection were skin, postoperative, intravenous catheter site and cellulitis. Initial febrile response was seen in 93.1% of patients with 48.1% having temperature greater than 38.3 degrees C. Hypotension (blood pressure less than 90/50 mm Hg) was noted in five out of the 29 (17.1%) patients. Clinical diagnosis of disseminated intravascular coagulation was made in two out of the 29 (6.9%) patients. Underlying risk factors were poor nutrition, respirator dependency, indwelling Foley catheters and manipulative procedures. Incidence and mortality rates are similar to the non-SCI population as reported elsewhere. The risk factors are different; therefore preventive management is extremely important.
J Am Paraplegia Soc
PMID:Bacteremia in the spinal cord injury population. 357 93

The disseminated intravascular coagulation syndrome is an untoward side effect of metastatic adenocarcinoma of the prostate. In addition to appropriate replacement of blood, platelets and clotting factors, prompt treatment of the prostatic carcinoma is required to correct the underlying pathophysiological defect. Ketoconazole is the ideal method for hormonal manipulation for patients with life-threatening complications of prostatic carcinoma (disseminated intravascular coagulation and acute paraparesis/paraplegia) because of its prompt onset of action in decreasing circulating concentrations of androgens to castrate levels. Serum testosterone levels are castrate within 48 hours of the initiation of therapy with ketoconazole as opposed to a minimum of 10 to 14 days with estrogens. A patient with spontaneous bleeding from disseminated intravascular coagulation was treated with 400 mg. ketoconazole every 8 hours and bleeding stopped within 48 hours. Ketoconazole is particularly valuable when a prompt therapeutic response is needed and orchiectomy is contraindicated because of bleeding diathesis (as in disseminated intravascular coagulation), delay in histological confirmation (as in acute paraparesis/paraplegia) or patient reluctance to undergo castration.
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PMID:The use of ketoconazole in the emergency management of disseminated intravascular coagulation due to metastatic prostatic cancer. 357 56

Eighteen patients whose mean age was 61 years were referred to us with acute aortic occlusion from 1977 to 1985. Ten patients had cardiac emboli (group I) and eight had aortoiliac occlusive disease (group II). Fourteen of these patients had paresis or paralysis. Diagnosis was prompt but the time lapse from onset of symptoms to revascularization averaged 18 hours (group I, 10.3 hours; group II, 26.1 hours). All 10 patients in group I had embolectomy alone; of the eight patients in group II, two had transfemoral thrombectomy and six had bypass procedures. The perioperative mortality rate was 40% in group I and 62.5% in group II. Complications developed in 12 patients (nine died); renal failure occurred in 11, compartment syndrome in nine, adult respiratory disease syndrome in three, acute myocardial infarction in three, disseminated intravascular coagulation in two, and paraplegia in one. No amputations were required in the nine survivors and limb function was restored in eight of these patients. Acute aortic occlusion sets in motion a chain of events that threatens life and limb. Prompt diagnosis and revascularization by the simplest operation are required to decrease morbidity and mortality.
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PMID:Acute aortic occlusion--a multifaceted catastrophe. 374 30

By damaging cell membrane integrity, acute rhabdomyolysis leads to electrolyte shifts according to the concentration gradients and the liberation of intracellular substances. Diagnosis is confirmed by the presence of a high serum creatinkinase activity (CK) and myoglobinuria. For clinical purposes myoglobinuria is demonstrated by a blood-positive dipstick in the absence of hematuria or hemoglobinuria. Rhabdomyolysis is usually acquired and is rarely due to hereditary enzyme defects. The authors report on 61 patients admitted in the last 15 years with rhabodomyolysis. In the past 4 1/2 years the diagnosis was suggested by CK greater than 5000U/1 in 49 patients, representing 1.6% of all admissions in the departments of medicine and surgery. Originally described in crush situations, rhabdomyolysis has been observed with increasing frequency as a consequence of muscular stress and self crush due to coma or hemi- and paraplegia during the last decades. 24% of the patients with this diagnosis had had an intoxication, and in 70% there were multiple simultaneous causes. Autoimmune diseases, infections of bacterial, viral and fungal origin, endocrinopathies, and thermic and ischemic injuries can also provoke rhabdomyolysis. As a consequence of fluid shift into the damaged muscle a compartment syndrome may lead to vascular or neural defects. In 80% of cases there is initial hypocalcemia, turning later into hypercalcemia. Other frequent electrolyte disorders accompanying rhabdomyolysis are hyperkalemia, hyperphosphatemia and a widened anion gap. 6 of 13 patients showed the typical blood changes found in patients with disseminated intravascular coagulation. Acute renal failure developed in 30 patients, 15 of whom underwent dialysis or hemofiltration.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Acute rhabdomyolysis]. 395 76

A review of the records of 100 consecutive patients undergoing surgical repair of abdominal aortic aneurysms disclosed two individuals who presented in a fashion sufficiently rare as to warrant detailed discussion. The first had concomitant rupture and thrombosis manifested by lower extremity paraplegia and anesthesia, and the second had documented DIC in conjunction with a stable aneurysm. The latter completely resolved with heparin and subsequent surgical repair. Each of these presentations has had documentation in the surgical literature in less than five instances, and both case histories are given, followed by a review of the literature and theories as to the underlying pathophysiology.
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PMID:Unusual presentations of abdominal aortic aneurysms. 721 87

We report a 24-year-old man who presented unilateral multiple cranial nerve involvements followed by progressive paraplegia. The patient expired after developing DIC and pneumonia. Post-mortem examination revealed Ewing's sarcoma originated in the pubic bone with extensive metastases including the clivus which was responsible for his cranial nerve lesions. The patient was well until 24 years of age when he noted an onset of pain and a mass in the pubic region. The histology of the biopsy specimen of the tumor suggested Ewing's sarcoma. He was treated with chemotherapy and local radiation. A year after, he noted an onset of nuchal pain, difficulty in tongue movement, dysarthria, deafness in the left ear, and diplopia. On admission to our hospital in July 1990, neurological examination revealed an alert and intelligent Japanese male in no acute distress. The olfactory to the trigeminal nerves appeared intact. He showed complete abducens nerve palsy, facial weakness, mild deafness, and weakness of the soft palate, the sternocleidomastoid muscle and the tongue, all on the left side. The remainder of the neurological examination was unremarkable except for dysesthesia along the left C8 and Th1 dermatoms. Radiological examination revealed a 10 x 10 cm sclerotic mass in the public bone and a high signal mass lesion between the clivus and the pons in the T2-weighted MRI. His clinical course was complicated by acute paraplegia with anesthesia below the Th4 dermatom, DIC, and respiratory distress due to plural effusion. Post-mortem examination revealed a necrotic and hemorrhagic tumor in the pubic bone. The histology was consistent with Ewing's sarcoma.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A 24-year-old man presenting Garcin syndrome and paraplegia]. 847 71

A 63-year-old woman suddenly began to suffer from left chest pain. She gradually became unable to walk and was admitted to the emergency room at another hospital. When she became paraplegic in spite of steroid therapy, she was admitted to our hospital. Her affliction was diagnosed as anterior spinal artery syndrome because of flaccid paraplegia and dissociated sensory loss below the Th4 dermatome. Hematological study indicated a compensated DIC and hepatic enzyme abnormality, while the CSF examinations showed an elevation of protein and positive myelin basic protein (MBP) elevation. The initial MRI taken in the acute stage showed no abnormal signals on T1-weighted (T1) and Gd-enhanced images. The sagittal T2-weighted image (T2) revealed central high intensity (HI) with longitudinal extension from Th2 through the Th11 vertebral level. On axial T2, HI was located on the gray matter at the Th3 and Th4 vertebral level, the ventral two-thirds at the Th8 vertebral level, the central ventral side at the Th9 and Th10 vertebral level, and the entire cross section at the Th12 and L1. A follow-up MRI examination showed that the range of HI on the sagittal T2 had been reduced to 5 segments from Th6 through Th10 vertebral level. The T2 HI lesion on the axial aspect had become reduced so as to localize on the left ventral side at the Th8 vertebral level and on the central ventral side at Th9 and Th10.
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PMID:[Serial MRI study on a case of anterior spinal artery syndrome]. 1007 31

Neurological complications following viper bite are uncommon and are generally as a result of intracerebral or subarachnoid bleed and rarely due to cerebral infarction. We report a young male who following viperine bite developed local tissue swelling, haemorrhagic manifestations due to disseminated intravascular coagulation and later developed acute flaccid paraplegia as a result of dorsal spinal cord involvement.
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PMID:Acute paraplegia following viper bite. 1258 76

We describe a case of a massive haemorrhage after dorsal decompressive laminectomy. The biological syndrome was at first a disseminated intravascular coagulation (DIC), rapidly complicated by a secondary fibrinolysis. The usual treatment of DIC with plasma and platelet transfusion failed to control bleeding and the patient underwent four repeat operations for relapsing rapidly evolving paraplegia. Aprotinine treatment stopped the haemorrhage. The vertebral metastasis causing spinal compression proved to be of prostatic origin.
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PMID:[Massive haemorrhage after dorsal decompressive laminectomy]. 1600 94


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