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)

Streptococcal toxic shock syndrome with the initial manifestation of abdominal pain and cholecystitis is rare. We report the case of a 10-year-old boy who presented with abdominal pain, cholecystitis and shock initially. Acute respiratory distress syndrome, renal and hepatic insufficiency and disseminated intravascular coagulation developed soon after admission. Skin rash and desquamation were found subsequently during the recovery phase. The blood and sputum cultures were sterile. Acute and convalescent plasma from the patient showed increased anti-streptolysin O titer (ASLO titer). Measurement of the ASLO titer on Day 11 after the onset of disease had an ASLO titer of 242 IU/ml (N Latex ASL, Dade Behring Marburg GmbH, USA), and the ASLO titer on Day 21 after the onset of disease showed an increase to 875 IU/ml. These clinical findings and the plasma analysis were consistent with streptococcal toxic shock syndrome.
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PMID:Streptococcal toxic shock syndrome with initial manifestation of abdominal pain and cholecystitis. 1630 90

Streptococcal toxic shock syndrome (STSS) associated with a group A beta hemolytic streptococcal infection was described 18 y ago. Since then, although the pathophysiology of the syndrome has been clarified, mortality can be as high as 80%. A middle-aged female developed STSS associated with a group A streptococcal pneumonia. Laboratory studies confirmed respiratory and renal failure as well as disseminated intravascular coagulation with a striking reduction in endogenous procoagulants. The patient, probably due to her HLA DRB1*14 haplotype was unable to generate anti-streptococcal antibodies. She was treated with appropriate antimicrobial therapy together with intravenous gamma globulin and drotrecogin or activated protein C. Her response to this combined therapy was accompanied by a rapid resolution of the multiorgan failure and correction of the accompanying disseminated intravascular coagulation. This rapid response to treatment supports the hypohesis that several host factors including the immune response and loss of procoagulants determine the development and severity of the toxic shock syndromes. Further studies with this combined approach appear warranted.
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PMID:An early favorable outcome of streptococcal toxic shock syndrome may require a combination of antimicrobial and intravenous gamma globulin therapy together with activated protein C. 1714 61