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 premature infant with acute necrotizing enterocolitis, Escherichia coli sepsis, and disseminated intravascular coagulation developed spontaneous bilateral hyphemas at 3 days of age. The necrotizing enterocolitis was associated with gas bubbles in the intestinal walls. The anterior chambers of both eyes also contained bubbles of gas, formed possibly by a mechanism similar to those in the intestine.
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PMID:Pneumatosis oculi and spontaneous hyphema in association with pneumatosis intestinalis. 38 51

Serial quantitative immunoelectrophoretic (IE) measurements of antithrombin III heparin cofactor (AT III) were made in groups of well and sick newborn infants classified by gestational age. Collection methods (venous vs. capillary) did not influence the results; serum IE measurements were comparable to AT III activity by a clotting method. AT III is gestational age-dependent, increasing from 28.7% of normal adult values at 28--32 weeks to 50.9% at 37--40 weeks, and shows a gradual increase to term infant levels (57.4%) by 3--4 weeks of age. Infants with the respiratory distress syndrome (RDS) show lower levels of AT III in the 33--36 week group, 22% vs. 44% and in the 37--40 week group, 33.6% vs. 50.9%, then prematures without RDS. Infants of 28--32 week gestational age had only slight differences, RDS = 24%, non-RDS = 28.7%. The lowest levels of AT III were seen in patients with RDS complicated by disseminated intravascular coagulation and those with necrotizing enterocolitis. Crossed IE on representative infants displayed a consistent pattern which was identical to adult controls except for appropriate decreases in the amplitude of the peaks. The thrombotic complications seen in the sick preterm infant may be related to the low levels of AT III.
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PMID:Immunologic studies of antithrombin III heparin cofactor in the newborn. 70 91

Serial determinations of the absolute granulocyte and platelet counts were performed in 40 infants with severe neonatal necrotizing enterocolitis. Fourteen of the 38 infants had absolute granulocyte counts less than 1,500 nm3, the mean absolute granulocyte count was significantly lower in the group of infants who died during the acute episode of NEC as compared to that of the infants who survived. Thrity-five of 40 infants had nadir platelet counts less than 150,000/nm3, clinical bleeding occurred in 12 of the thrombocytopenic infants. Fourteen thrombocytopenic infants were evaluated for disseminated intravascular coagulation by additional coagulation studies; six were noted to have laboratory evidence of DIC. We conclude that (1) a low absolute granulocyte count in severe NEC is associated with a poor prognosis and (2) thrombocytopenia is a significant problem in severe NEC and may occur with or without evidence of fulminant intravascular coagulation.
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PMID:Hematologic abnormalities in severe neonatal necrotizing enterocolitis. 127 Nov 73

Disseminated intravascular coagulation (DIC) and other clotting abnormalities are common in sick newborn infants who have a variety of conditions. To document evidence of DIC at autopsy, immunoperoxidase staining of fibrin-related antigens (FRA) was used to detect intravascular microthrombi in liver, kidney, and lung from 127 newborns. Patients were selected from seven major disease groups: hyaline membrane disease/bronchopulmonary dysplasia, infection, meconium aspiration, necrotizing enterocolitis, congenital heart disease, other congenital anomalies, and extreme prematurity. Staining for FRA in intravascular microthrombi was seen in 40% of cases studied. The liver showed the highest frequency of intravascular microthrombi, located predominantly in the sinusoids. Unlike the adult kidney, the newborn kidney seldom had evidence of intravascular coagulation. Extravascular staining of FRA was observed in the renal distal tubular epithelium in 48 cases, many of which also had evidence of intravascular FRA staining. No significant differences in FRA staining patterns were seen among the disease groups except for cases of extreme prematurity in which all tissues showed minimal staining. Control tissues from SIDS patients also showed minimal FRA staining. Hepatic sinusoidal staining was the only tissue finding that correlated with thrombocytopenia, a clinical indicator of DIC. Despite the use of this immunohistochemical staining method, discrepancies between the clinical and autopsy diagnosis of DIC remain.
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PMID:Immunohistochemical diagnosis of disseminated intravascular coagulation in newborns. 170 Apr 4

Hemorrhagic and thrombotic complications are common in sick preterm infants and may reflect inadequate regulation of coagulation. All neonates have low levels of the pivotal regulator antithrombin III (ATIII) compared with adults. Plasma levels of ATIII are very low in preterm infants and are further diminished in infants with respiratory distress, necrotizing enterocolitis, sepsis, or disseminated intravascular coagulation. Babies with lower levels of ATIII in the cord blood have been shown to have a worse outcome than neonates with levels appropriate for gestational age, including higher mortality and increased incidence of intracranial hemorrhages and catheter-related thromboses. The origin of severe ATIII deficiency is unknown. Therapies with plasma replacement or anticoagulation have decreased the incidence and severity of hemorrhagic and thrombotic complications in high-risk infants in several clinical trials. These data lay the groundwork and rationale for potential use of ATIII replacement in deficient preterm infants.
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PMID:Neonatal antithrombin III deficiency. 267 71

Various biochemical and structural changes affecting the newborn's wellbeing develop as a result of perinatal asphyxia. Central nervous system abnormalities are frequent complications with high mortality and morbidity. Cardiac compromise may lead to dysrhythmias and cardiogenic shock. Coagulopathy in the form of disseminated intravascular coagulation or massive pulmonary hemorrhage are potentially lethal complications. Necrotizing enterocolitis, acute renal failure, and endocrine problems affecting fluid electrolyte balance are likely to occur. Even the adrenal glands and pancreas are vulnerable to perinatal oxygen deprivation. The best form of management appears to be anticipation, early identification, and prevention of potential obstetrical-neonatal problems. Every effort should be made to carry out effective resuscitation measures on the depressed infant at the time of delivery.
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PMID:Asphyxia neonatorum. 371 11

The clinical presentation, diagnostic features, therapeutic measures, and results of treatment of 29 infants with the firmly established diagnosis of necrotizing enterocolitis are reviewed. A cohort of control patients are studied in an attempt to identify risk factors which may predispose infants to develop this serious complication of the newborn period. The incidence of necrotizing enterocolitis in our series is 1.2 per 1000 live births, similar to that reported by other investigators. The prognosis is particularly grave in infants of very low birth weight and among those who exhibit radiographic evidence of portal venous air or who develop disseminated intravascular coagulation.
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PMID:Necrotizing enterocolitis of the newborn. 709 69

Mortality was assessed in a nine-year experience with 123 patients with necrotizing enterocolitis. Overall mortality was 45%. Despite intestinal perforation among surgically treated patients, there was no difference in mortality between surgically or medically treated patients(46% vs 54%). Patients with only hematochezia or abdominal distention has a lower mortality than those who appeared "septic" (35% vs 68%). Similarly, those with bacteremia and disseminated intravascular coagulation had high mortality as well as those in whom peritonitis with ascites developed. When the entire patient population is considered, prior therapy with ascites developed. When the entire patient population is considered, prior therapy with systemic antibiotics or concomitant therapy with oral aminoglycosides had no effect on severity of the disease, occurrence of intestinal perforation, or mortality.
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PMID:Neonatal necrotizing enterocolitis: a nine-year experience. II. Outcome assessment. 724 87

A therapeutic trial of transfusions with polymorphonuclear leukocyte concentrates was performed in newborn infants with bacterial sepsis proven by blood culture. With each transfusion, 20 ml/kg of a preparation obtained by continuous flow filtration leukapheresis, and containing 0.5 to 1 x 10(9) WBC, with less than 6% lymphocytes, was administered. Twenty newborn infants with sepsis received from 2 to 15 PMN transfusions. Results were compared with findings in 18 newborn infants with sepsis admitted during the trial period, and not treated because of unavailability of the PMN preparation (Group B). Infants with fulminant illness were excluded from both groups. Groups A and B were similar with respect to clinical characteristics and to etiology (in the majority cases a highly antibiotic-resistant Klebsiella). The mortality rate was significantly lower in Group A than in Group B in the whole series (10% vs 72%, P < 0.001), and also in the subgroups with birth weight equal or below 1,500 gm (10% vs 91%, P < 0.001). Major complications and associated conditions (i.e., necrotizing enterocolitis, meningitis, pneumonia, peritonitis, osteoarthritis, disseminated intravascular coagulation) were observed in 12 patients of Group B, and in only three infants of Group A. Untoward effects attributable to PMN transfusions were never observed. PMN transfusion was a highly effective therapeutic tool in our population of infected newborn infants.
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PMID:Polymorphonuclear leukocyte transfusion for the treatment of sepsis in the newborn infant. 745 87

During the 19-month study period, 48 (2 per cent) of the 2177 neonates admitted to the neonatal intensive care unit (NICU) yielded Pseudomonas aeruginosa growths in blood cultures. All these neonates had clinical and haematological evidences of sepsis. Prominent clinical features included sclerema, violaceus necrotic patches, necrotizing enterocolitis (NEC), conjugated hyperbilirubinaemia, and DIC. Over all mortality was 23 per cent, distinctly higher in premature neonates with RDS. The mean gestational age and birth weights (+/- SD) of these neonates were 36.42 (+/- 2.73) weeks and 2173.34 (+/- 567.33) g, respectively. Approximately half of the total cases had low birth weight. Other adverse perinatal events before the development of sepsis included birth asphyxia (60 per cent), neonatal resuscitation (67 per cent), meconium aspiration syndrome (29 per cent), hyaline membrane disease (8 per cent), prolonged hospitalization (44 per cent), closed incubator care (17 per cent), prolonged intravenous fluids (42 per cent), repeated blood sampling (63 per cent), and umbilical catheterization (4 per cent). Analysis of the trend of Pseudomonas sepsis in our NICU revealed six definite outbreaks (more than two cases) interspersed with occasional (one or two) cases. Six study months, however, remained free of Pseudomonas sepsis. Index case was demonstrable on seven occasions. Bacteriological surveillance of the NICU after onset of initial case/cases revealed statistically significant colonization of resuscitation equipment, baby placement sites, and various cleansing solutions by the same bacterial species (P < 0.05). It is possible that Pseudomonas was introduced to our NICU from transfer admissions from other hospitals since on four occasions index case was the one transferred from outside.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Epidemiology of Pseudomonas aeruginosa infections in a neonatal intensive care unit. 844 85


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