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)

Platelet aggregation was undertaken in platelet rich plasma in 34 heat-stroke patients during the Muslim pilgrimage (Haj) to Makkah; 18 were males and 16 were females; their ages ranged from 36 to 80 years (mean SD = 58 10). Platelet aggregability, on arrival at the Heatstroke Centres, was markedly inhibited in response to adrenaline, collagen, arachidonic acid and ristocetin but not to ADP. Responses to decreasing ADP doses (20.0, 2.0, 1.0 and 0.5 micromol/l) showed hyperaggregability in 12 patients, inhibited responses in 16 and normal responses in 6 patients. Aggregation responses were not significantly different when comparing patients with bleeding manifestations ( n = 10), with those without bleeding ( n = 24). Haemostatic parameters including plasma fibrinogen, ATIII and platelet count, were markedly reduced in the two patient groups who showed hyperaggrebable and depressed aggregation responses, but not in those with normal responses. These results lead us to conclude that: (1) platelet activation is a frequent feature of heatstroke; (2) in heatstroke altered aggregation responses, whether hyperaggregable or depressed, occur simultaneously with a consumption coagulopathy.
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PMID:The role of platelets in the coagulopathy of heatstroke- a study of platelet aggregation in heatstroke patients during the Makkah pilgrimage (Haj) to Makkah. 1679 31

A thorough review of the literature and of personal files has allowed the gathering of 81 patients with rare congenital bleeding disorders and thrombotic phenomena. Sixteen of these patients had congenital afibrinogenemia, eight involved factor V deficiency, 20 factor VII defects, 33 factor XI deficiencies and only one, a factor XIII defect. Altogether 42 patients showed arterial thrombosis (myocardial infarction [MI] in 28 cases; ischemic stroke in 4; arterial occlusion in 8; 2 patients with disseminated intravascular coagulation (DIC)). Ages varied between 13 and 74. Twenty-two patients were males and 16 females. In four cases, sex was not reported. There were three fatalities: two after a MI and one because of heart failure. With regard to venous thrombosis: 9 patients had pulmonary embolism, 15 patients had deep vein thrombosis, 9 patients had both pulmonary embolism and deep vein thrombosis; 1 patient had superficial vein thrombosis, whereas, 5 cases had an unusual site venous thrombosis (two portal systems, two cerebral sinuses, one inferior vena cava) for a total of 39 cases. Age varied between 3 and 86. In this case, 20 patients were males and 17 were females. In two cases, sex was not reported. There were three fatalities: two because of pulmonary embolism and one because of inferior vena cava thrombosis. The fact that thrombosis has never been described in patients with factor II or factor X seems to underscore the central antithrombotic role that these two factors have in the coagulation system.
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PMID:Arterial and venous thrombosis in rare congenital bleeding disorders: a critical review. 1683 33

Heat stroke is a potentially fatal disorder that's caused by an extreme elevation in body temperature. We report here an unusual case of multiple organ failure that was caused by classical, nonexertional heat stroke due to taking a warm bath at home. A 68 year old diabetic man was hospitalized for loss of consciousness. He was presumed to have been in a warm bath for 3 hrs and his body temperature was 41degrees C. Despite cooling and supportive care, he developed acute renal failure, disseminated intravascular coagulation (DIC) and fulminant liver failure. Continuous venovenous hemofiltration was started on day 3 because of the progressive oligouria and severe metabolic acidosis. On day 15, septic ascites was developed and Acinetobacter baumanii and Enterococcus faecium were isolated on the blood cultures. In spite of the best supportive care, the hepatic failure and DIC combined with septic peritonitis progressed; the patient succumbed on day 25.
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PMID:A case of multiple organ failure due to heat stoke following a warm bath. 1701 75

Ischaemic stroke in thromboembolic mechanism may be a first sign of neoplastic disease, as in the presented case of a 56-year-old woman. Progressive trombocytopenia, anaemia with reticulocytosis and schistocytes in peripheral blood smear, elevated serum LDH activity as well as coexisting myocardial infarction initially suggested Moschcowitz syndrome. However, plasma exchange did not improve her neurological status and D-dimer values increase in subsequent evaluations indicated chronic DIC. At the same time, on transesophageal echocardiography, thrombotic endocarditis was diagnosed. Screening for cancer showed high CA 125 marker and chest computed tomography revealed lung tumor, not visible on earlier chest X-ray. In further treatment she underwent palliative radiotherapy and continued low molecular weight heparin. The neoplastic process had an unfavorable course and she died after four months. The authors point out that in case of multifocal ischaemic stroke and coexistent thrombocytopenia, neoplastic hypercoagulable state and thrombotic endocarditis should be considered.
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PMID:[Multifocal ischaemic stroke and myocardial infarction in a woman with occult lung cancer complicated with chronic DIC and thrombotic endocarditis]. 1719 80

Superior sagittal sinus thrombosis (SSST) has been reported to be caused by coagulopathy following oral contraceptive therapy, DIC, infection around the sinus, compression from a tumor, infiltration of tumor, and an inherited deficiency of proteins C and S, but SSST associated with hematological malignancies and L-asparaginase (L-Asp) therapy is rare. We report a case of an adult patient with acute lymphoblastic leukemia (ALL) who developed SSST during the remission induction therapy. A 25-year-old man was admitted with left facial nerve palsy and, following bone marrow aspiration and lumbar puncture, he was diagnosed as having T-ALL with CNS involvement. He received a 1-AdVP regimen as remission induction therapy and intrathecal administration of methotrexate and cytarabine. On day 29, he had a generalized convulsion and SSST was demonstrated by imaging tests. Lymphoid malignancy (ALL in particular), the use of L-Asp, CNS involvement, and intrathecal chemotherapy might be risk factors for the occurrence SSST. When a patient with those factors develops any neurological symptoms, we should pay attention to the occurrence of SSST, as well as stroke or CNS involvement, though SSST is rare.
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PMID:[Superior sagittal sinus thrombosis during remission induction therapy for acute lymphoblastic leukemia]. 1723 72

A 73-year-old man underwent a facial skin biopsy, after which he experienced persistent, severe bleeding over a 4-day period that could not be staunched by suturing or cauterization. Patient history suggested a bleeding diathesis. A condition of chronic disseminated intravascular coagulation (DIC) that decompensated into an acute state of DIC subsequent to the biopsy was diagnosed based on laboratory findings. Physical examination followed by imaging revealed a large abdominal aortic aneurysm as the likely underlying etiology. The patient achieved stability with blood component replacement therapy and an initial round of heparin that was substituted with enoxaparin. Following cardiac catheterization, where triple vessel coronary artery disease was diagnosed, surgical correction of the abdominal aortic aneurysm and coronary artery bypass grafting were deemed to be too high risk. The patient was treated medically for his abdominal aortic aneurysm, coronary artery disease, and acute and chronic DIC. Within a year, the patient succumbed to a brainstem stroke. In patients with acute or chronic DIC, a thorough examination is recommended to exclude rare causes and to improve overall general management.
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PMID:The secret behind profuse bleeding following a routine skin biopsy. 1739 55

Stroke in patients with cancer is second only to metastasis as a cause of focal neurological deficit. Stroke in this setting is usually linked to mucinous tumors or hematologic malignancies. We describe 2 patients with cervical cancer who developed disseminated intravascular coagulation (DIC)-mediated cerebral infarctions. The protean manifestations of DIC in cancer patients with stroke are emphasized.
J Stroke Cerebrovasc Dis
PMID:Disseminated intravascular coagulation and stroke associated with cervical cancer. 1789 87

Systemic hemostatic activation following primary intracerebral hemorrhage (PICH) has been described, particularly with intraventricular or subarachnoid extension. Our objective was to study the occurrence of abnormalities of coagulation as measured by partial thromboplastin time, international normalized ratio, and platelet count in patients with PICH and no obvious cause for a pre-existing coagulopathy. Charts of PICH patients admitted between November 1991 and December 2001 were reviewed. We excluded patients with an underlying lesion, cranial trauma, anticoagulation, liver failure or sepsis. All patients had partial thromboplastin time, international normalized ratio, and platelet count measured on admission. An international normalized ratio > 1.4, partial thromboplastin time > 35, and platelet count < 100,000 were considered abnormal based on standardized values for our laboratory. All patients underwent a computed tomography (CT) scan on admission. Repeat CT was obtained for evidence of neurological deterioration. One hundred ninety-two patients with intracerebral hemorrhage were studied. Thirty-seven were excluded because of a possible underlying cause for a pre-existing coagulopathy. Thirteen of one hundred and fifty-five (8.4%) patients were found to have a coagulopathy based on our criteria. Three of thirteen (23%) patients with coagulopathy versus 3/142 (2%) without suffered neurological deterioration with evidence of hematoma enlargement (P = .008). Eleven of sixty-seven (17%) patients with intraventricular/subarachnoid extension versus 2/88 (2%) without had a coagulopathy (P = .002). Eight of thirteen (61%) patients with coagulopathy versus 29/142 (20%) without were dead at 30 days (P = .003). Coagulation abnormalities without an obvious etiology that may be consistent with low grade disseminated intravascular coagulation are seen in 8.4% of patients with PICH and are associated with extension into the subarachnoid and intraventricular compartments, neurological deterioration with hematoma expansion, and mortality at 30 days. This may represent a target for therapeutic intervention.
J Stroke Cerebrovasc Dis
PMID:Coagulation abnormalities following primary intracerebral hemorrhage. 1790 49

We conducted a retrospective study of the management and outcome for eclampsia patients in the intensive care unit (ICU) of National hospital, Abuja between November 2001 and April 2005 (42 months). The patients' case files and ICU records were used to extract the necessary data. During the study period, there were a total of 4857 deliveries, with 5051 total births (including multiple births) and 4854 live births. Forty eclamptics were admitted to the ICU, giving an ICU admission rate of 8.2/1000 live births. The records of two patients were incomplete. The average age of the patients was 28.4 years (range 17-4 years). Six patients (15.8%) were booked and 32 (84.2%) were not. The average duration of stay in ICU was 5 days. Twenty patients (52.6%) had antepartum eclampsia, 12 (31.6%) had postpartum eclampsia and six (15.8%) presented with intrapartum eclampsia. Twenty-nine (76.3%) gave birth via caesarean section and nine (23.7%) delivered per vagina augmented by oxytocin infusion. Seventeen (45%) received mechanical ventilation; 20 (53%) received oxygen via nasal prongs, nasal catheters or variable performance facemask. One patient (2%) did not receive oxygen therapy. All the patients were admitted postpartum. There were 11 maternal deaths, giving a case fatality rate of 29%. There were five (45.4%) deaths due to haemolysis, elevated liver enzymes and low platelet count syndrome and two (18.2%) due to disseminated intravascular coagulation. The remaining deaths were due to cerebrovascular accident (9.1%), lobar pneumonia (9.1%), acute renal failure (9.1%) and multiple organ failure (9.1%). All patients were admitted postpartum. This fatality rate is higher than that detailed in the reports reviewed in this study. Early referral of eclamptics or at risk patients to a tertiary care institution may help reduce morbidity and mortality. In addition, early referral to a facility providing basic essential obstetric care or comprehensive essential obstetric care is also important. Another important factor is the correct diagnosis of pre-eclampsia during antenatal and postpartum care by screening, noting blood pressure levels, performing urinalysis for protein and asking about warning signs such as headache, blurred vision, epigastric pain, etc.
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PMID:Critical care management of eclamptics: challenges in an African setting. 1830 51

We report a case of hyperglycemic shock associated with hepatic portal venous gas. A 79-year-old woman with post-stroke depression developed severe tachycardiac atrial fibrillation and hypotension due to hypovolemia caused by severe hyperglycemia, as well as showing disseminated intravascular coagulation (DIC). Continuous intravenous infusion of insulin and volume loading with normal saline gradually achieved normalization of the serum glucose level and hemodynamic stability. However, the DIC did not resolve, and abdominal computed tomography (CT) revealed hepatic portal venous gas (HPVG) in the left lobe of the liver. Surgery was thus considered mandatory. However, because severe hemodynamic lability occurred again immediately after the CT examination, and persisted, surgery could not be performed, and the patient died of septic shock due to bowel perforation. It was concluded that the underlying causes of DIC should be sought promptly, without delay.
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PMID:Severe hyperglycemic shock associated with hepatic portal venous gas. 1830 20


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