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)

The authors reviewed the case records of 1419 children with acute leukemia and other types of malignant disease involving the bone marrow to define the clinical and laboratory features associated with marrow necrosis as well as the prognostic significance of this complication. Only seven patients were found to have this abnormality: four with newly diagnosed acute lymphoblastic leukemia (ALL), one with relapsed ALL, and two with disseminated neuroblastoma. All patients presented with severe bone pain, bone tenderness, and fever. Levels of serum lactic dehydrogenase were uniformly increased, being especially high in patients with ALL. There was no evidence of severe infection or disseminated intravascular coagulation, complications that have been causally related to marrow necrosis. Four of the five children with ALL remain in complete remission for 10+ to 48+ months. Both patients with neuroblastoma are off therapy, in remission, for 9+ to 15+ months. In contrast to earlier reports, bone marrow necrosis does not appear to confer a poor prognosis in children with malignancy.
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PMID:Bone marrow necrosis in children with malignant disease. 386 Dec 29

We have experienced 30 patients with neuroblastoma since 1975. Disseminated intravascular coagulation (DIC) developed in six of these patients. They were all in stage IV, namely disseminated neuroblastoma. These six cases with DIC proved that some advanced neuroblastomas have the potential to cause coagulopathy in the process of the disease. The plasma concentration of heparin was measured in some patients who were treated with heparin. The data revealed that the conventionally used intravenous heparin dose is not appropriate in the case of DIC. Effective treatment requires monitoring of the plasma concentration of heparin.
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PMID:Advanced neuroblastoma and disseminated intravascular coagulation: report of six cases. 405 31

A 51-year-old man presented with headache, vomiting and exophthalmus. Neurological examination revealed anosmia, papilledema, decrease in visual acuity, and disability in ocular movement. MRI showed a huge mass which occupied the whole nasal cavity and compressed the frontal lobe upwards and the eyes laterally. CT revealed an extensive bony destruction of the frontal base and bilateral orbits. The mass was biopsied transnasally, and was histologically diagnosed as olfactory neuroblastoma. It was highly radiosensitive and disappeared with a local irradiation of 40 Gy. Three months later the patient complained of a pain radiating from the neck to the right arm. MRI demonstrated a metastasis at the vertebral body of C5. Local irradiation of 30 Gy was performed. The metastatic lesion was removed, and a bone graft taken from the iliac bone was transplanted via an anterior cervical approach. Three weeks later, however, a hard mass appeared in the right of his neck and was surgically removed. By histological examination, it was also identified as a metastatic neuroblastoma to the cervical lymph node. A week after the removal of the cervical metastatic lesion, the metastasis extended rapidly to the left cervical and the bilateral hilar lymph nodes of the lungs. Chemotherapy was performed with a total doses of 800mg of cyclophosphamide, 1.5mg of vincristine, 40mg of pirarubicin, and 80mg of cisplatin. The lesions disappeared within 7 days. However, the patient died from disseminated intravascular coagulation 10 months after the onset. Olfactory neuroblastoma is usually an intranasal neoplasm, but it rarely extends intracranially and intraorbitally as is shown in our case. Basically, olfactory neuroblastoma is a relatively slow-growing tumor though it has a tendency to develop local recurrences over long periods even after aggressive primary treatment, and accompanied with distant metastases. However, our patient showed a very short survival time. Invasive extension and multiple metastases occurred during a short period, followed by disseminated intravascular coagulation. Combined chemotherapy at the initial treatment may be recommended in such an extensive case.
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PMID:[A case of olfactory neuroblastoma with intracranial, intraorbital extension and multiple metastases]. 902 94