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)

Loxosceles species are widely distributed. People are most at risk for bites when they disturb the nocturnal spider's habitat. The bite sequelae range from insignificant, to disseminated intravascular coagulation and renal failure. Patients most frequently seek care for slow-healing necrotic skin lesions. Early surgical excision is not recommended. Conservative local care usually suffices. Dapsone may benefit some patients. Specific antivenom given early may minimize sequelae.
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PMID:Loxosceles reclusa envenomation. 199 56

A previously healthy 35-year-old woman was seen at 37 weeks' gestation with a 10-day history of fever, vomiting, diarrhea and malaise. Serum laboratory findings included elevation of serum bilirubin and AST, prolongation of serum prothrombin time and a positive monospot. A tentative diagnosis of acute fatty liver of pregnancy was made, and a healthy male infant was delivered by emergency cesarean section because of fetal distress. Over the subsequent 3 days, acute progressive oliguric renal failure, disseminated intravascular coagulation, hypoglycemia requiring intravenous dextrose infusion and pancreatitis developed; her mental status progressed to stage III encephalopathy. Quantitative computed tomography estimated the liver volume to be 770 cm3. The decision to proceed with orthotopic liver transplantation was made on the basis of progressive clinical deterioration despite aggressive support and because of her small liver size. After transplant, the patient's multisystem failure rapidly reversed. Histopathological examination of the native liver demonstrated predominantly zone 3 microvesicular steatosis with characteristic ultrastructural changes consistent with acute fatty liver of pregnancy. Southern blot analysis for Epstein-Barr virus DNA was negative. We conclude that orthotopic liver transplantation should be considered for the small group of patients with fulminant hepatic failure associated with acute fatty liver of pregnancy who manifest signs of irreversible liver failure despite delivery of the fetus and aggresive supportive care.
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PMID:Fulminant hepatic failure caused by acute fatty liver of pregnancy treated by orthotopic liver transplantation. 240 63

Hepatic arterial infusion chemotherapy with cisplatin (CDDP) and adriamycin (ADR) in combination with angiotensin-II (AT-II) was performed in 19 cases of hepatocellular carcinoma (HCC), 16 cases of metastatic liver tumor (MLT) and one case of cholangiocellular carcinoma. CDDP (60-120 mg) and ADR (20-50 mg) were infused into the hepatic artery with intra-arterial instillation of AT-II (0.5-1.5 microgram/min). Transcatheter arterial embolization (TAE) was additionally performed in 10 cases of HCC and 3 cases of MLT. The response rates for infusion chemotherapy combined with TAE were 44% in HCC and 67% in MLT. On the other hand, the response rates without TAE were 0% in HCC and 42% in MLT. In some cases of HCC, however, a marked decrease in serum alpha-fetoprotein levels was observed despite the lack of effectiveness evaluated by CT scan and angiography. Although minor side effects were noted such as a mild degree of leukocytopenia and/or thrombocytopenia and hepatic and/or renal dysfunction, they were only temporary with a duration of less than 3 or 4 weeks. In 4 patients with HCC without TAE treatment, however, lethal side effects occurred including pancytopenia, hepatic failure and disseminated intravascular coagulation, and they died within 2 months after infusion chemotherapy. Renal failure was not seen in either group.
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PMID:[Hepatic artery infusion chemotherapy with cisplatin and adriamycin in combination with angiotensin-II in the treatment of malignant liver tumors]. 245 73

After an accidental or intentional ingestion of lindane, clinical manifestations of poisoning may include rapid onset of nausea and vomiting, coma, seizures, respiratory failure, and death. While rhabdomyolysis, secondary renal failure, and aplastic anemia have also been reported, coagulopathies have not been observed following poisoning with this pesticide. In this case report we describe a 43-year-old female who intentionally ingested 8 oz of a 20% lindane solution. Her serum lindane concentration reached 1.3 mcg/ml and her clinical manifestations included seizures, coma, rhabdomyolysis, secondary renal failure, and disseminated intravascular coagulation. The coagulopathy presented early in her clinical course and resolved when serum lindane levels fell. The patient died 11 days after the ingestion.
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PMID:Disseminated intravascular coagulation in a case of fatal lindane poisoning. 245 26

1. The concentration in plasma of fibrinogen derivatives fibrinopeptide A (FPA) and B beta 1-42 and the platelet release products beta-thromboglobulin (beta TG) and platelet factor 4 (PF4) have been determined in patients with acute and chronic liver disease. 2. In 21 patients with fulmiant hepatic failure on admission in grade III or IV coma the plasma FPA, B beta 1-42, beta TG and PF4 levels were significantly increased compared with those in normal control subjects. On heparinization before haemoperfusion the FPA levels returned to the normal range and during resin and charcoal haemoperfusion there were no significant changes in the coagulation or platelet factors, except for a small increase in FPA with charcoal haemoperfusion. 3. In ten patients with compensated chronic liver disease there was a significant increase in B beta 1-42 and beta TG levels but not FPA and PF4 as compared with normal controls. 4. Interpretation of the results is complicated by the possible reduced clearance of these proteins as a result of renal failure in some of the patients with fulminant hepatic failure and also by the damaged liver itself. However, these results have confirmed that disseminated intravascular coagulation can occur in both acute and chronic liver disease.
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PMID:Fibrinogen derivatives and platelet activation products in acute and chronic liver disease. 248 73

There have been five confirmed cases of severe Chlamydia psittaci infection during pregnancy, three having been treated in Edinburgh, Scotland. The most recent case is presented and previous experience is reviewed. The illness usually causes thrombocytopenia with disseminated intravascular coagulation, renal failure and hepatic dysfunction during the late second and early third trimester. The outcome for the fetus is usually fatal and the infection only resolves after delivery or abortion. The main hope is for education to prevent infection occurring in susceptible populations.
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PMID:Sheep-acquired severe Chlamydia psittaci infection in pregnancy. 256 61

Hemorrhage is a prominent feature of hemorrhagic fever with renal syndrome (HFRS) in China. It occurs in all phases of the disease and is an important cause of death. Petechiae involving skin and oropharyngeal mucosa are the commonest manifestation of hemorrhage, occurring in more than 90% of patients. Gastrointestinal hemorrhage is the next commonest manifestation, occurring in approximately 50% of patients. Suggested mechanisms of hemorrhage include vascular injury, thrombocytopenia and platelet dysfunction, disseminated intravascular coagulation, circulating heparin-like activity, and uremia. Controlled trials of treatment regimens for hemostatic impairment in HFRS have not been performed. Support of blood pressure can lessen hemorrhage by limiting the adverse consequences of hypotension and shock. Dialysis is of benefit in patients with hemorrhage and significant renal failure.
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PMID:Hemorrhage in hemorrhagic fever with renal syndrome in China. 256 78

Hantaviruses, the causative agents of HFRS, have become more widely recognized. Epidemiologic evidence indicates that these pathogens are distributed worldwide. People who come into close contact with infected rodents in urban, rural and laboratory environments are at particular risk. Transmission to man occurs mainly via the respiratory tract. The epidemiology of the hantaviruses is intimately linked to the ecology of their principal vertebrate hosts. Four distinct viruses are now recognized within the hantavirus genus and that number is likely to increase to six very soon; however, further investigations are necessary. Much more work is still needed before we fully understand the wide spectrum of clinical signs and symptoms of HFRS as well as the pathogenicity of the different viruses in the hantavirus genus of the Bunyaviridae family. HFRS is difficult to diagnose on clinical grounds alone and serological evidence is often needed. A fourfold rise in IgG antibody titer in a 1-week interval, and the presence of the IgM type of antibodies against hantaviruses are good evidence for an acute hantavirus infection. Physicians should be alert for HFRS each time they deal with patients with acute febrile flu-like illness, renal failure of unknown origin and sometimes hepatic dysfunction. Especially the mild form of HFRS is difficult to diagnose. Acute onset, headache, fever, increased serum creatinine, proteinuria and polyuria are signs and symptoms compatible with a mild form of HFRS. Differential diagnosis should be considered for the following diseases in the endemic areas of HFRS: acute renal failure, hemorrhagic scarlet fever, acute abdomen, leptospirosis, scrub typhus, murine typhus, spotted fevers, non-A, non-B hepatitis, Colorado tick fever, septicemia, dengue, heartstroke and DIC. Treatment of HFRS is mainly supportive. Recently, however, treatment of HFRS patients with ribavirin in China and Korea, within 7 days after onset of fever, resulted in a reduced mortality as well as shortened course of illness.
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PMID:Hemorrhagic fever with renal syndrome. 257 14

Abruptio placentae rarely produces severe maternal complications while the fetus is alive in utero. The advent of fetal death (grade III) indicates a severe form of abruptio placentae and a real risk that an overt coagulopathy might develop (grade IIIB). Overt coagulopathy associated with a live fetus is, however, uncommon. The advent of an overt coagulopathy should be viewed as ominous. Treatment of abruptio placentae with overt coagulopathy should be directed toward obtaining a rapid and atraumatic vaginal delivery. Once delivery has occurred, spontaneous reversal of the coagulopathy can be anticipated. In the opinion of one of the authors (G.S.), the advent of severe consumption coagulopathy and/or uterine inertia is an indication for intravenous therapy with aprotinin. It has been shown that such therapy will limit DIC, reverse fibrinolysis, reawaken uterine activity, and lead to rapid vaginal delivery within 6-8 hours. Aprotinin is not commercially available for clinical use in the United States. Prolongation of the abruption-delivery interval will worsen maternal prognosis. Accordingly, the advent of uterine inertia prior to complete cervical dilatation is an indication for immediate cesarean section in circumstances where aprotinin is not available. Following delivery, the physician should be on the lookout for postpartum hemorrhage, which may necessitate immediate transfusion, the administration of oxytocics, and/or uterine manipulation. Surgical intervention is rarely indicated in such cases. The patient should also be carefully observed over the ensuing days and weeks for the evolution and resolution of complications, such as renal failure, pulmonary insufficiency, and panhypopituitarism.
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PMID:Abruptio placentae with coagulopathy: a rational basis for management. 258 Jun 57

A 32-year-old woman with acute salpingitis had signs and symptoms of sepsis, with hypotension, renal failure, acute respiratory distress syndrome, and disseminated intravascular coagulation. Streptococcus pyogenes group A was grown from blood cultures taken at the onset of illness, and salpingitis was confirmed at laparotomy. The patient recovered after appropriate antimicrobial and intensive supportive therapy.
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PMID:Septic shock and acute respiratory distress syndrome after salpingitis caused by Streptococcus pyogenes group A. 265 6


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