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)

A patient had severe pneumonia, respiratory failure, and disseminated intravascular coagulation caused by Chlamydia psittaci. Cutaneous findings included a maculopapular blanching rash, acrocyanosis, superficial venous thromboses, and splinter hemorrhages under the fingernails. The history of exposure to potential vectors of psittacosis and the presence of some or all the cutaneous findings described herein may lead to the early recognition of psittacosis.
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PMID:Cutaneous findings in a case of psittacosis. 647 61

Multiple extremity gangrene developed in five patients as a complication of dopamine therapy. The clinical conditions were (1) penetrating chest trauma requiring pneumonectomy with postoperative sepsis, (2) cardiac arrest with aspiration pneumonia, (3) lymphoma with sepsis, (4) Klebsiella pneumonia, and (5) myocardial infarction. The development of acrocyanosis leading to gangrene occurred at dopamine dosages of 5.1 to 10.2 micrograms/kg/min. The alpha-adrenergic vasoconstriction effects of dopamine would not be expected from the doses employed in these patients. Thus, other factors beside pure alpha vasoconstriction are responsible for tissue necrosis after the use of dopamine. We believe that the embolic complications of disseminated intravascular coagulation and hypovolemia are serious risk factors in the development of dopamine gangrene. Peripheral vasoconstriction from dopamine, even at low doses, may set the stage for thrombotic complications of disseminated intravascular coagulation and lead to tissue damage. In laboratory models of disseminated intravascular coagulation, an alpha-adrenergic drug is required to produce peripheral ischemic tissue damage. Treatment of tissue ischemia related to dopamine depends on early recognition of acrocyanosis. Phentolamine, an alpha blocker, has been recommended for treating dopamine ischemia, either through local instillation into ischemic tissues or intravenous infusion. We recommend a high index of suspicion for, and early treatment of, underlying consumptive coagulopathy in all patients requiring dopamine.
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PMID:Dopamine gangrene. Association with disseminated intravascular coagulation. 730 16

Symmetrical peripheral gangrene (SPG), seen in a wide variety of medical conditions presents as symmetrical gangrene of two or more extremities without large vessel obstruction or vasculitis. Fingers, and toes (rarely nose, ear lobes or genitilia) are affected. It may manifest unpredictably in conditions associated with sepsis, low output states, vasospastic conditions, myeloproliferative disorders or in hyperviscosity syndrome. It carries a high mortality rate with a very high frequency of multiple limb amputations in survivors. Disseminated intravascular coagulation (DIC) is seen in majority of cases of SPG. A more or less stereotyped clinical picture of SPG in spite of ever widening aetiological spectrum is suggestive of DIC as the final common pathway of its pathogenesis. Early recognition of acrocyanosis, quick reversal of DIC, effective management of the underlying condition, haemodynamic stabilization and (perhaps) anticoagulation with low dose heparin (300-500 iu/hour) may be helpful in arresting the progression of pre-gangrenous changes to frank gangrene. Vasopressors such as dopamine should be used judiciously in the presence of DIC. Development of acrocyanosis and increase in serum lactate levels may be indicative of impending SPG and the imperative need to treat DIC as well as the underlying condition.
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PMID:Symmetrical peripheral gangrene. 1495 59

A 45-year-old man presented with a 4-day history of high-grade fever with rigours and a 2-day history of painful bluish black discolouration of extremities (acrocyanosis). He was haemodynamically stable and all peripheral pulses palpable, but the extremities were cold with gangrene involving bilateral fingers and toes. Mild splenomegaly was present on abdominal examination but rest of the physical examinations were normal. On investigating he was found to have anaemia, thrombocytopaenia with gametocytes of Plasmodium falciparum on peripheral blood smear. His blood was uncoagulable during performance of prothrombin time with a raised D-dimer. Oxygen saturation was normal and the arterial Doppler test showed reduced blood flow to the extremities. A diagnosis of complicated P. falciparum malaria with disseminated intravascular coagulation (DIC) leading to symmetrical peripheral gangrene was performed. Artemisinin combination therapy was started and heparin was given for DIC. A final line of demarcation of gangrene started forming by 12th day.
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PMID:Symmetrical peripheral gangrene due to Plasmodium falciparum malaria. 2486 24

Disseminated intravascular coagulation (DIC) is linked with severe COVID-19, prompting considerable concern. DIC can be a devastating systemic disorder. It is often markedly manifest on the skin as acrocyanosis or as petechiae and purpura with progression to hemorrhagic bullae. Subcutaneous hematomas may occur, as may thrombotic findings including necrosis and gangrene. The most common cause is infection, with special emphasis now on COVID-19. We have reviewed the medical literature under the search terms "Disseminated intravascular coagulation" and "consumption coagulopathy" for the past two decades in the English language using Medline and Google Scholar to update special concerns and considerations, focusing on those with COVID-19. Skin findings with DIC may be prominent. The severity of cutaneous lesions often correlates with the gravity of systemic disease. DIC is most effectively treated by addressing the underlying cause and resuscitating the patient using supportive measures. It is pivotal to recognize and treat DIC early, before deadly complications, such as multiple organ failure, arise.
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PMID:Disseminated intravascular coagulation: A devastating systemic disorder of special concern with COVID-19. 3270 Aug 13