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)

Primary malignant nephrosclerosis shows a haemolytic-uraemic symptomatology and can be differentiated from secondary malignant nephrosclerosis on clinical and histological grounds. The disease was observed in 4 patients: a 25-year-old man and 3 women aged 19, 28 and 49 years. The disease is characterized by a fulminating course, malignant hypertension with progressive retinopathy, and development of progressive renal failure with subsequent irreversible anuria. In addition haemolytic anaemia or posthaemolytic states as well as consumption coagulopathy occur. In 2 cases schizozytes and in particular helmet-shaped forms could be demonstrated. On histology an obliterating necrotizing vascular change is seen which is limited to the kidneys as was demonstrated in one case by angiography. Therapeutic attempts included antibiotics, steroids, heparin, streptokinase, antihypertensive drugs, and haemodialysis. The 3 female patients died, the man survived after bilateral nephrectomy.
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PMID:[Primary malignant nephrosclerosis (author's transl)]. 112 2

In all, 55 eyes of 55 patients were examined prospectively in random order with the Humphrey field analyzer [central field 76 points, full threshold strategy, single-stimulus presentation, response-button control (HFA 1); central field 76 points, defect-depth strategy, response-button control (HFA 2)] and the Dicon TKS-4000 [central field 76 points, defect-depth strategy, multiple-stimulus presentation, response-button control (DIC 1); central field 76 points, defect-depth strategy, multiple-stimulus presentation, voice control (DIC 2)]. Some 26 patients (47%) had glaucomatous field defects, 7 patients (13%) had lesions of the visual pathway, 5 patients (9%) had normal fields. The other 17 patients (31%) had field defects due to vascular lesions of the retina or the optic nerve, retrobulbar neuritis, cataract, dysthyroid optic neuropathy, disorders of the macula, or human immunodeficiency virus (HIV) retinopathy. The mean testing time for the whole study population was 5.2 +/- 2.7 min for DIC 1. The difference from the mean testing time for HFA 2 (6.4 +/- 2.7 min) is statistically significant (p = 0.0013). DIC 2 reduces the mean testing time to 4.9 +/- 2.6 min. The difference from DIC 1 is not statistically significant (p = 0.8110). A multiple-stimulus presentation and voice control seem to be useful methods to reduce the testing time in automated perimetry without a loss of accuracy. Voice control, as used in the DICON TKS 4000, still has to be improved, however.
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PMID:Multiple-stimulus presentation and voice control in automated perimetry. 147 32

At the Kiel University Department of Gynaecology, 21 patients between the 21th and 39th week of gestation were treated in 1987 and 1988 following diagnosis of HELLP syndrome. At the time of diagnosis all patients presented an advanced gestosis/eclampsia. 9 patients developed the classical signs and symptoms, while hospitalised. The typical signs of gestosis, hypertension, proteinurea, oedema and hypoproteinaemia preceded the changes in laboratory values caused by the HELLP syndrome. Upper abdominal pain and increase in transaminase values occurred on the average 3.4 or 2.7 days prior to the decrease of, thrombocyte count. In 19 of the 21 cases, pregnancy was terminated by caesarean section. Severe peripartal complications occurred in 7 cases e.g. foetal death in utero (n = 3), eclampsia (n = 5), renal failure (n = 2), cerebral oedema (n = 1), intracerebral haemorrhage (n = 1), disseminated intravascular coagulation (n = 1), abdominal wall haematoma (n = 1). 6 of these patients were admitted after complications had occurred prior to admittance. All 18 infants born alive survived the neonatal period. The average birth weight was 1,571 g. 11 infants were discharged clinically normal. The remaining infants included 5 cases pointing to retinopathy and 3 cases of cerebral palsy. One infant developed post-haemorrhagic hydrocephalus.
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PMID:[Development of symptoms and perinatal complications in HELLP syndrome]. 177 22

Retinopathy occurring during toxemia of pregnancy generally shows the features of hypertensive retinopathy. The authors describe the case of a patient with bilateral peripheral neovascularizations following toxemia of pregnancy. The likely pathogenesis is ascribed to the development of ischemic areas, which can be determined by microthrombus formation. Presently, low-grade disseminated intravascular coagulation is considered very important in the pathogenesis of toxemia of pregnancy. After panretinal fluorangiography, a selective photocoagulation of ischemic areas was performed. The regression of neovascularizations was observed after one month. No similar case report could be found in the literature.
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PMID:Proliferative retinopathy and toxemia of pregnancy. 243 70

Proteolytic enzymes, lipase, kinins, and other active peptides liberated from the inflamed pancreas convert inflammation of the pancreas, a single-organ disease of the retroperitoneum, to a multisystem disease. Adult respiratory distress syndrome, in addition to being secondary to microvascular thrombosis, may be the result of active phospholipase A (lecithinase), which digests lecithin, a major component of surfactant. Myocardial depression and shock are suspected to be secondary to vasoactive peptides and a myocardial depressant factor. Coagulation abnormalities may range from scattered intravascular thrombosis to severe disseminated intravascular coagulation. Acute renal failure has been explained on the basis of hypovolemia and hypotension. The renin-angiotensin alterations in acute pancreatitis (AP) as mediators of renal failure need to be studied. Metabolic complications include hypocalcemia, hyperlipemia, hyperglycemia, hypoglycemia, and diabetic ketoacidosis, of which hypocalcemia has been long recognized as an indicator of poor prognosis. The pathogenesis of hypocalcemia is multifactorial and includes calcium-soap formation, hormonal imbalances (e.g., parathyroid hormone, calcitonin, glucagon), binding of calcium by free fatty acid-albumin complexes, and intracellular translocation of calcium. Subcutaneous fat necrosis, arthritis, and Purtscher's retinopathy are rare. The various prognostic criteria of AP and other associated laboratory abnormalities are manifestations of systemic effects. Early recognition and appropriated management of these complications have resulted in improved prognosis of severe AP.
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PMID:Acute pancreatitis: a multisystem disease. 804 85

Thrombomodulin is an endothelial cell surface glycoprotein that forms a 1:1 complex with thrombin. In this form, thrombin can activate approximately 1,000-fold more protein C than thrombin alone and does not activate coagulation factors, V and VIII, and platelets. Activated protein C inactivates factors Va and VIIIa. Thus thrombomodulin converts thrombin from a procoagulant protease to an anticoagulant. The soluble thrombomodulin present in human urine and plasma appears to represent a truncated form that lacks the transmembrane and cytoplasmic domains of tissue thrombomodulin. The plasma level of thrombomodulin has been used as a marker for endothelial injury in vivo. Elevated levels of soluble thrombomodulin were reported in the plasma from the patients with disseminated intravascular coagulation, adult respiratory distress syndrome (ARDS), and diabetes mellitus retinopathy.
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PMID:[Soluble thrombomodulin: as a marker of endothelial injury]. 805 97

We measured plasma levels of tissue factor (TF), total tissue factor pathway inhibitor (TFPI) and free TFPI antigen in patients with diabetes mellitus (DM), hyperlipidemia and disseminated intravascular coagulation (DIC). The mean TF, total TFPI and free TFPI antigen concentrations were significantly higher in patients with DM than in controls and the plasma TF concentration was significantly higher in patients with retinopathy or nephropathy than in DM with no complications. The mean TF, total TFPI and free TFPI antigen concentrations were significantly higher in patients with hyperlipidemia than in controls. There was a significant positive correlation between levels of total TFPI and total cholesterol. In patients with hyperlipidemia, the level of total TFPI was significantly decreased compared to base line level by cholesterol lowering drug, however, free TFPI concentration did not change by cholesterol lowering drug. The TF and total TFPI concentrations were significantly higher in patients with DIC than in controls.
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PMID:[Analysis of behaviors of plasma tissue factor and tissue factor pathway inhibitor in patients with various diseases]. 891 65

The case is described of a 32-year-old man suffering from alcoholism who came to the Emergency Unit with vomiting, fever and sharp epigastric pain irradiating to the chest and upper abdomen. A diagnosis of acute pancreatitis was made after high amylase and lipase levels were observed and the results of computed tomography scan revealed images typical of acute pancreatitis. Findings upon admission and after the initial 48 hours did not correlate with a severe or complicated course according to Ranson's criteria. On the third day after admission he suddenly developed decreased vision. A fluorescein angiogram showed arteriolar occlusion, retinal and choriocapillary ischaemia. Purtscher's retinopathy was suspected. After 4 weeks, the patient had recovered from acute pancreatitis, ophthalmoscopic examination showed normal results, and visual acuity had almost returned to normal. Activation of complement in acute pancreatitis could account for many haematologic acute disorders due to leucocyte emboli or other complement-mediated aggregates. Coagulation abnormalities may range from isolated intravascular thrombosis to severe disseminated intravascular coagulation. Purtscher's retinopathy, due to microembolizations in the choroidal and retinal arterioles, should be included among the various systemic effects of acute pancreatitis. This visual disorder is a rare systemic manifestation of acute pancreatitis which was not correlated to a severe or complicated clinical course. Treatment of these ocular complications remains to be established and outcome, therefore, depends upon resolution of the pancreatic disease.
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PMID:Acute pancreatitis with Purtscher's retinopathy: case report and review of the literature. 1114 85

Vascular stress at the level of the uterus-placental unit, with chronic placental ischemia, results in intrauterine growth restriction. Expectation management can be used, when the situation allows, in cases of compensated intrauterine growth restriction. The aim of the present study was to evaluate the neonatal prognosis of preterm births with and without growth restriction and term births with growth restriction in order to improve decisional accuracy regarding the termination of pregnancy. The frequency of term birth infants with low birth weight for gestational age was ~2%. The male sex, predominated only in the group of premature infants with normal weight for the gestational age. The highest frequency of neonatal complications studied occurred in the group of preterm neonates small for gestational age (SGA) with statistical significance obtained for cardiovascular arrest acute respiratory failure, ulcer-necrotic enterocolitis, respiratory distress, cerebral edema, intraventricular hemorrhage, cerebral hemorrhage, pulmonary hemorrhage, neonatal infection, hypoglycemia, retinopathy, anemia, hemorrhagic disease, disseminated intravascular coagulation, disease of hyaline membranes, neonatal sepsis, need for intensive neonatal therapy and death. In conclusion, immediate neonatal adaptation of SGA preterm neonates is more deficient than for preterm neonates with appropriate weight for gestational age; the adaptation of preterm neonates, in turn, is more deficient than term newborns with intrauterine growth restriction. The term newborns with intrauterine growth restriction have a neonatal adaptation comparable to that of the term newborns with weight corresponding to the gestational age.
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PMID:Unfavorable influence of prematurity on the neonatal prognostic of small for gestational age fetuses. 3276 26