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Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

At Asama General Hospital, we experienced six cases of urosepsis with septic shock during a period of five years between 1989 and 1993. All six patients, whose average age was 74 years old, recovered. In four patients, the condition was caused by obstructive uropathy. The remaining two cases were caused by renal inflammatory disease, which was complicated by diabetes mellitus. One of them was renal abscess with renal papillary necrosis, and the other was emphysematous pyelonephritis. The patients, who exhibited symptoms such as gram-negative bacteremia, severe hypotension, tachycardia, decrease of urine volume and mental disturbance, were diagnosed with urosepsis with septic shock. In all cases, symptoms such as a high fever of over 39 degrees C, hypoxemia and thrombocytopenia were observed. Renal dysfunction was found in 67%, and both liver dysfunction and disseminated intravascular coagulation (DIC) were found in 50% of the cases. Since no patients suffered from adult respiratory distress syndrome, a high survival rate was apparent. Anti-shock therapy and anti-coagulation therapy were ineffective for the patients who had septic shock due to urinary tract obstruction. Urinary tract drainage was required to treat the latter patients. Nephrectomy could not be avoided in renal parenchymatous inflammatory disease. In the future, what might be essential in therapeutics against urosepsis with septic shock, particularly to avoid nephrectomy, are the treatments such as immunotherapy against endotoxins and their mediators, and hemoperfusion for the removal of endotoxins.
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PMID:[Clinical study on 6 cases of urosepsis associated with septic shock]. 989 24

Xanthogranulomatous pyelonephritis (XPN) is a rare form of chronic pyelonephritis, which is usually caused by calculous obstructive uropathy. We present a previously healthy 45-year-old housewife, who was admitted to The Dammam Central Hospital, Dammam, Saudi Arabia with left loin pain and increased frequency of micturition of four days duration. She also had icterus and features of disseminated intravascular coagulation. Abdominal ultrasound and computed tomography of the abdomen was suggestive of XPN. She responded well to treatment with antibiotics and nephrectomy. Histology of the resected kidney confirmed a diagnosis of XPN. Our case suggests that the diagnosis of XPN should be kept in mind when a middle-aged female patient presents with unilateral non-functioning hydronephrotic kidney, which is totally distorted, and has enhancing as well as non-enhancing regions on computed tomography.
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PMID:Atypical presentation of xanthogranulomatous pyelonephritis: a case report. 1723 98

A 51-year-old woman with adenomyosis was admitted because of anemia with schistocytosis, thrombocytopenia, and acute renal failure (ARF). Thrombotic microangiopathy (TMA) was considered. Plasma exchange and steroid therapies improved laboratory results. However, renal biopsy specimen revealed acute tubular necrosis (ATN), but not TMA, and thrombocytopenia, diagnosed it as disseminated intravascular coagulation (DIC) but not TMA. Few cases of DIC associated with benign tumors of the uterus and, especially, adenomyosis have been reported. In adenomyosis patients, ARF is usually caused by obstructive uropathy. However, the rare case suggests that hemolytic anemia, DIC, and ARF due to ATN can occur in adenomyosis patients.
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PMID:A case of anemia with schistocytosis, thrombocytopenia, and acute renal failure caused by adenomyosis. 2200 63