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)

In order to elucidate the activation of the coagulation cascade in patients with malignant neoplasms, we measured the levels of plasma prothrombin fragment F1 + 2, which is liberated in the process of thrombin generation. Twenty healthy adults (Group A), 29 patients with malignancies not complicated with DIC (Group B) and 4 patients with DIC (Group C) were evaluated. The values of F1 + 2 in Group C (2.38 +/- 0.55 nmol/l) were significantly higher (p < 0.01) than those in Group A (0.52 +/- 0.19 nmol/l) and B (0.86 +/- 0.68 nmol/l). Many patients in Group B showed higher levels of F1 + 2 compared to normal subjects, however, no significant differences were found between Group A and B. With respect to other coagulation molecular markers such as TAT, D-Dimer and PIC, F1 + 2 levels revealed positive correlation to those levels. Concerning the clinical course of DIC, elevated levels of F1 + 2 normalized much rapidly than those of TAT and D-Dimer by continuous administration of heparin. In conclusion, the measurement of plasma F1 + 2 is important in monitoring the activation of coagulation system in patients with malignancies, especially with respect to early detection and treatment of DIC.
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PMID:[Evaluation of hypercoagulable state in patients with malignancies by using prothrombin fragment F1 + 2]. 146 81

We examined the hemostatic abnormality of liver disease using hemostatic molecular markers, i.e. TAT, FPA and SFMC for coagulation, B beta 15-42, FDP, D dimer and PIC for fibrinolysis, t-PA and TM for vessel wall. The molecular markers for coagulation were generally increased in cases of liver disease, which was most sensitively reflected by FPA. On the other hand, it was postulated that SFMC was a marker reflecting the complication of DIC in these cases. Hyperfibrinolysis of liver disease was sensitively reflected by the increase of B beta 15-42, and an occasional increase of SFMC or FDP was thought to indicate the complication of DIC in these cases. A high correlation was found between t-PA and TM. It was postulated that the increase of the both markers in liver disease was due to deteriorated clearance by liver dysfunction, although TM is regarded as a marker reflecting endothelial injury. It was expected that visualization of hemostatic disorder of liver disease was made practical with the use of radar chart of these molecular markers.
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PMID:[Analysis of hemostatic abnormality in various disease using molecular-I. Liver disease]. 182 41

In order to clarify the abnormalities of blood coagulation and fibrinolysis in patients with various renal diseases, some molecular markers for hemostasis and thrombosis were examined in comparison with those of the patients with disseminated intravascular coagulation. The results were as follows: 1) PIC was significantly higher in the patients with CGN, NS, SLE, HD and DIC than normal subjects. 2) TAT was significantly higher in the patients with CGN, NS, HD and DIC. 3) SFMC was significantly higher only in the patients of DIC. 4) FDP and FDP-E were significantly higher in the patients with HD and DIC. 5) D-dimer was significantly higher in the patients with CGN, CRF, HD and DIC. These results suggested that the abnormalities of blood coagulation and fibrinolysis in patients with various renal diseases are relatively mild, and situated between the normal subjects and patients with DIC.
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PMID:[Studies on molecular markers for hemostasis and thrombosis in various renal diseases]. 183 16

To evaluate the diagnostic and prognostic value of PIC, we compared it with the DIC score (which is calculated from platelet count, fibrinogen, FDP, and prothrombin time). We examined 182 samples from 60 patients with coaglo-fibrinolytic abnormalities. For the diagnosis of DIC, the sensitivity of PIC was significantly higher than that of DIC score (78.46% vs 43.08%; chi 2-test p less than 0.01), although the specificity of PIC was significantly lower than that of DIC score (32.48% vs 69.23%; chi 2-test p less than 0.01). For the prediction of prognosis, the peak value of PIC and DIC score during the patient's clinical course were evaluated. The non-survivors (n = 33) had significantly higher levels of peak PIC and DIC scores than the survivors (n = 27) (peak PIC: 6.1 + 9.0 micrograms/ml vs 2.2 + 3.3, p less than 0.05; peak DIC score: 4.6 + 2.4 points vs 3.3 + 2.2, p less than 0.05). The patients with a peak PIC of more than 4.0 micrograms/ml had a mortality of over 90%. These results show that PIC is a useful diagnostic and prognostic parameter.
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PMID:[Alpha 2plasmin-inhibitor . plasmin complex (PIC)--useful diagnostic and prognostic parameter]. 183 70

Determination of FDP D-dimer (D-dimer) has been recently developed for the diagnosis of thrombotic diseases with secondary fibrinolysis. We have studied the correlation between D-dimer and FDP-E concentrations in plasma from 282 patients with 630 samples. A linear correlation (r = 0.9269) was observed between the values of FDP-E and D-dimer. However, 13 out of 282 cases revealed an apparent dissociation of D-dimer concentrations from FDP-E values. Among them, 4 of these 13 cases (Group A) have shown to possess higher level of D-dimer when compared with the expected values from FDP-E, while 9 of 13 cases (Group B) revealed lower levels of D-dimer than that expected from FDP-E. All of Group A patients have been diagnosed as disseminated intravascular coagulation (DIC). On the other hand, in Group B patients, 6 of 9 were shown to have a widespread metastasis of cancer and 2 of them were under treatment with urokinase. To study whether Group B patients were under hypercoagulable or hyper-fibrinolytic state, we have examined ratios of AT III/alpha 2 PI and PIC/TAT in these cases. It has been shown that 4 of 9 patients in Group B have higher ratios of both AT III/alpha 2 PI and PIC/TAT if compared with other patients than Group B. This suggests that patients in Group B have been under hyper-fibrinolytic states.
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PMID:[Study on cases of D dimer values were dissociated from FDP-E]. 205 6

Because of pre-thrombotic state frequently present in the elderly, sepsis easily progresses to pre-DIC and DIC, sometimes with a fatal outcome. We assessed 31 elderly patients who developed pre-DIC and DIC due to severe infection. They were divided into two groups, early death group: 14 elderly patients with poor prognosis died within 14 days, and long survival group: 17 patients with good prognosis lived 15 days or more. Controls consisted of 31 elderly thrombotic disease cases and 25 healthy elderly cases. The DIC score was significantly higher in the early death group than in the long survival group, and there was a correlation between DIC score and survival. Moreover, many of the early death group were long-termed bed-ridden patients, serum BUN and Cre levels were significantly increased in the early death group compared to the long survival group. While plasma TAT, PIC and D-dimer levels were increased in thrombotic disease group compared to the healthy control group, TAT and D-dimer were also increased in the pre-DIC and DIC state than in the thrombotic state. In the early death group, D-dimer was higher than in the long survival group. We suggest that early diagnosis by molecular marker is important in the DIC stage, and a high D-dimer level may be a poor prognostic factor.
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PMID:[Disseminated intravascular coagulation (DIC) and pre-DIC due to severe infection in the elderly]. 785 38

I have experienced 35 cases of DIC in my department during last 8 years. These cases were divided into a septic and non-septic groups based on their back-ground, and compared their clinical symptoms and various laboratory findings. The results showed the septic DIC group could be characterized as follows: (1) impairment of the vital organs was more clearly manifested, while hemorrhagic symptoms were mild, (2) the laboratory tests showed almost no tendency for fibrinogen or alpha 2-PI to be decreased or PIC to be increased, (3) the blood PAF (Platelet Activating Factor) level was clearly higher and showed an inverse relationship with the platelet count. On the basis of these clinical findings, I speculated septic DIC involves suppression of secondary fibrinolysis and participation of PAF. In experiment A, I investigated the effects of endotoxin (Et) on the activity of plasminogen activator (PA) in the rabbit renal cortex. In both in vitro and in vivo systems, I could demonstrate the renal cortex PA activity was significantly suppressed by Et. Then, in experiment B, I could confirm, (1) PAF caused a drop in the blood pressure and a decrease in the platelet count that were similar to those induced by Et, and that Et caused a decrease in the platelet count that was inversely accompanied by an increase in PAF, (2) PAF antagonist showed greater efficacy than a protease inhibitor in suppressing the decrease in the blood platelet count.
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PMID:[Clinical and experimental studies of septic DIC in surgical patients, in terms of its characteristic features and pathogenesis]. 787 83

Despite of many investigations addressing the problem on the diagnosis of DIC associated with liver diseases, however, an adequate clinical and laboratory criteria has not yet been established. We attempted to clarify this problem by evaluating the changes of plasma levels of PIC, D dimer, TAT and several endothelial factors in 20 patients with severe liver disease who had the evidence of hemorrhage, and were treated with AT III concentrate and gabexate mesilate (FOY). In patients who show a good response to treatment, plasma levels of PIC and D dimer before treatment were both significantly higher (p < 0.01) than those in patients who did not respond, while there was no significant difference in other coagulation fibrinolysis parameters except for platelet count which showed rather lower in the response group (p < 0.05). We believe that combination assay for both PIC and D dimer will be adequate to differentiate whether the hemostatic abnormalities are induced mainly by DIC or hepatic insufficiency.
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PMID:[Adequate parameters for the diagnosis of disseminated intravascular coagulation (DIC) in patients with liver diseases]. 838 86

The early stage of the state in which coagulation or fibrinolytic pathway is activated has been difficult to be estimated. Recently, it has become possible to detect an early stage of DIC (pre-DIC) due to the development of highly sensitive methods which quantitate so called "molecular markers". Molecular markers can be classified into three groups: 1) activation fragments of coagulation proteins (e.g. F1+2); 2) protease and its inhibitor complex (e.g. TAT, IXa-AT-III, Xa-AT-III and PIC); 3) degradation products (e.g. FPA, FPB beta, SFMC and D-dimer). Among them, F1+2, TAT, FPA and SFMC reflect in vivo thrombin generation, while PIC, FPB beta and D-dimer reflect in vivo plasmin generation. IXa-AT-III and Xa-AT-III may be useful markers to detect hypercoagulable states in an earlier stage of underlying various disorders. Measurement of circulating levels of the zymogens and protease inhibitors is unable to detect small changes caused by low grade DIC or localized thrombotic events. Monitoring plasma levels of molecular markers, however, gives us more specific and accurate information regarding the onset and time course of hypercoagulable states and enable us to diagnose DIC at an early stage and to evaluate the effect of treatment for patients with DIC, specifically.
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PMID:[Diagnosis of predictive state of disseminated intravascular coagulation]. 843 31

Blood coagulation tests are useful to diagnose some thrombotic diseases. Particularly, these tests are valuable for the diagnosis of familiar thrombophilia, antiphospholipid antibody syndrome (APS) and disseminated intravascular coagulation (DIC). For the diagnosis of thrombophilia, determinations of both biological activity and antigen level of antithrombin III, protein C and protein S are important for initial screening. Since activated protein C (APC) resistance is extremely rare in Japanese, APC resistant test that based on APTT, is unnecessary to include as one of the screening tests. Detection of activity and antigen level of either plasminogen or fibrinogen is recommended to screen the plasminogen deficiency or dysfibrinogenemia. Determination of lupus anticoagulant is needed for the diagnosis of APS. At this time, the dilute phospholipid APTT (dAPTT) or the dilute Russell viper venom time (dRVVT) may be useful as a screening test for LA because procedure of these tests are basically simple to perform in Japanese laboratory. In the next step, cross mixing test of dAPTT (or APTT) should be perform to make a diagnose of LA more solid. Final confirm tests can be conveniently carried out with kit of either STACLOT or LA-CONFIRM. Platelet count and FDP (or FDP D dimer) assay are two essential tests for the diagnosis of DIC. Criteria of diagnosis for DIC recommended by Blood Coagulation Research Group of Japanese Ministry of Health and Welfare is not unnecessarily appropriate for practical use. TAT and PIC can be a good laboratory tests for early detection of hypercoagulable state in patients with DIC.
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PMID:[Clinical diagnosis of thrombosis and blood coagulation tests]. 956 63


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