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 statement that amniotic fluid embolism is the most dangerous and untreatable condition in obstetrics appears to be true. It must be suspected in any patient who collapses or bleeds excessively during labour or the immediate post-partum period. Attempts should be made to secure a definitive diagnosis in life by examination of blood obtained from the right side of the heart and the sputum for elements of amniotic fluid. Lung scanning is a useful aid to diagnosis. The principal factors that have been implicated in the clinical syndrome of amniotic fluid embolism are anaphylaxis, vascular obstruction by particulate matter, vascular spasm due to prostaglandins and possibly some other vasoactive substances, and the possibility that all the changes could be explained by disseminated intravascular coagulation as a primary event. Further work is required to elucidate the relative contributions of these various factors. Due to the suddeness of the catastrophe and the very high mortality, haemodynamic data in humans is virtually non-existent. With improved methods of resuscitation it is to be hoped that the mortality rate will be reduced and that such data will become available. In this way it might become possible to apply the results of animal research and indicate the most effective method of treatment.
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PMID:Amniotic fluid embolism. 37 60

Prothrombin complex concentrates are used in the treatment of the congenital bleeding disorders associated with Factors II, VII, IX, and X deficiencies. They have also been extensively used to treat acquired coagulation abnormalities secondary to vitamin K deficiency, warfarin ingestion, and various types of liver disease. The reported complications of prothrombin complex concentrates administration include hepatitis, anaphylaxis, and thrombosis. This paper documents the development of disseminated intravascular coagulation in association with the administration of prothrombin complex concentrates to patients with liver disease.
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PMID:Intravascular coagulation with use of human prothrombin complex concentrates. 93 80

A case of sickle cell disease diagnosed postmortem is described. A 37-year-old black woman presented with anemia, respiratory distress, and abdominal and back pain. Death followed an intramuscular injection of iron, and anaphylaxis was clinically diagnosed. At autopsy, massive fat and necrotic bone marrow embolization of pulmonary and renal vessels was found. In the vertebral column, multifocal areas of ischemic necrosis were present, and proved to be the source of this embolization. Sickled red cells appeared in bone marrow sinusoids, and signs of disseminated intravascular coagulation were present.
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PMID:Massive fat and necrotic bone marrow embolization in a previously undiagnosed patient with sickle cell disease. 230 55

Topically applied thrombin was known to be effective in hemostasis of local bleeding, but complications of shock, anaphylaxis or disseminated intravascular coagulation (DIC) have been reported recently in rare cases. In this experiment, the possibility of DIC was examined by intraperitoneal injection of topical thrombin (Parke-Davis) to rabbits with liver cirrhosis or acute liver damages induced by CCl4. No significant changes in the coagulation parameters were found in the groups of liver cirrhosis or the untreated control, but the injection of thrombin induced decreases of platelet count and fibrinogen and prolongation of prothrombin time and partial thromboplastin time in the groups of acute liver damages, 24 or 48 hr after CCl4 injection. When the "junk" prepared from the topical thrombin was injected to the 48 hr-damage group, no change was noted in these parameters. It was concluded that DIC could be induced by the intraperitoneal injection of topical thrombin only in cases of acute liver damages, where the increased permeability of peritoneum was postulated. However, such an immediate or marked change in coagulation was not found in our experiment as encountered in the clinical cases, which suggested the involvement of the anaphylactic reaction to the topical application of thrombin in the development of DIC in these clinical cases.
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PMID:[Effect of intraperitoneal injection of topical thrombin on the coagulation and fibrinolysis of rabbits with experimental liver damages]. 398 69

The possible occurrence of DIC in active systemic anaphylaxis was investigated in mice. Induction of active systemic anaphylaxis resulted in the development of DIC symptoms such as thrombocytopenia, prolongation of prothrombin time, hypofibrinogaemia, and elevated level of fibrinogen/fibrin degradation products. In addition, in histological examinations, massive congestion and cellular infiltration in pulmonary interstitia, and considerable haemorrhage in renal medullae were observed. All these changes were nearly completely prevented by pretreatment with platelet-activating factor (PAF) antagonist (BN 50739). Moreover, the same haematological and morphological changes were produced by a bolus injection of PAF. These data strongly suggest that DIC occurs in active systemic anaphylaxis and PAF plays a pivotal role in the development of DIC in anaphylaxis.
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PMID:Occurrence of disseminated intravascular coagulation (DIC) in active systemic anaphylaxis: role of platelet-activating factor. 777 47

Although rare, exertional collapse and sudden death are the most serious potential complications of sickle cell trait. Studies suggest that this condition may occur in susceptible persons when poor physical conditioning, dehydration, heat stress or hypoxic states precipitate sickling of the abnormal erythrocytes. Sickling leads to endothelial damage, which can cause vasoconstriction, disseminated intravascular coagulation and local tissue damage. Cardiac effects include acute ischemia and arrhythmias. Muscle damage results in acute compartment syndromes and release of myoglobin into the circulation. Acute renal failure is possible. Diagnosis is based on a high index of suspicion, and characteristic presentation and laboratory findings, including myoglobinuria, hyperkalemia, hypocalcemia, hyperphosphatemia and elevated creatine kinase levels. The differential diagnosis includes pulmonary embolism, acute cardiac events, anaphylaxis and heat stroke. Management is based on stabilization, rehydration, and the treatment and prevention of complications.
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PMID:Exertional collapse and sudden death associated with sickle cell trait. 904 99

A 32-year-old woman was admitted with a diagnosis of impending premature delivery. In the 37th week of pregnancy, vaginal examination was performed. After ten minutes, vomiting, whole body flushing, and cold sweat appeared suddenly. Because fetal heart rate became 60-70 beats.min-1, emergency caesarean section was scheduled. When she arrived at the operating room, blood pressure was 75/45 and heart rate was 122 beats.min-1. Five minutes later, anesthesia was induced with thiopental and vecuronium, and operation was instituted concomitantly. After the delivery, pentazocine and midazolam were administered. During the operation, premature separation of normally implanted placenta or pressed cord was not observed. Hydrocortisone was administered for circulatory collapse. Gabexate mesilate was administered for the prevention of DIC. The scratch test, performed ten days later, revealed that latex was positive but lidocaine was negative. Therefore, it was concluded that anaphylaxis induced by latex gloves caused shock after internal examination.
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PMID:[A case of emergency caesarean section as a result of anaphylaxis to latex]. 1003 99

To examine the safety profile of products used to treat inhibitor patients unresponsive to factor VIII, a review of published clinical experience was performed. The products evaluated were activated prothrombin complex concentrates (aPCCs), such as AUTOPLEX T, porcine factor VIII and recombinant activated factor VII (rVIIa). Safety characteristics included potential for transmission of infectious agents, anamnesis, thrombogenicity, thrombocytopenia and allergic reactions. While viral transmission has been virtually eliminated, the risk is theoretically higher with plasma-derived products such as aPCC and porcine factor VIII than with rVIIa, although contamination of cultured cells is a concern. Anamnesis occurs with aPCCs and porcine factor VIII, and may induce resistance to further therapy with porcine factor VIII. Thrombosis and disseminated intravascular coagulation are very infrequently reported in patients exposed to aPCCs and rVIIa, and never with porcine factor VIII. The latter is occasionally associated with thrombocytopenia, but this uncommonly limits treatment with this agent. Lastly, allergic reactions occur with about equal frequency with all products, but anaphylaxis is mainly a concern after administration of porcine factor VIII. In conclusion, products currently available are reasonably safe. Considerations such as efficacy, availability, ease of administration and cost must also be considered in making treatment choices.
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PMID:Complications associated with the treatment of haemophiliacs with inhibitors. 1059 83

Although patients with cancer may derive much benefit from treatment, they are at risk for developing life-threatening complications. Hypersensitivity reactions can be severe, as in the case of anaphylaxis with L-asparaginase. Cardiac toxicities consist of arrhythmias with various drugs, hemorrhagic myocarditis with cyclophosphamide and ifosfamide, cardiomyopathy with anthracyclines, and pericardial disease. Acute respiratory failure may occur as a result of ARDS caused by ATRA or cytarabine, from interstitial fibrosis, or from pulmonary veno-occlusive disease. Hemorrhagic cystitis caused by cyclophosphamide and ifosfamide can be severe and result in exsanguination if unresponsive to treatment. Disseminated intravascular coagulation and thrombotic microangiopathy can produce thrombotic or hemorrhagic complications. Gastrointestinal toxicities include significant hepatotoxicity with a variety of drugs and development of acute surgical abdomen.
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PMID:Acute life-threatening toxicity of cancer treatment. 1152 52

Reports about anaphylactic and anaphylactoid reactions to rocuronium have increased recently. We report two new cases of documented grade III anaphylaxis, leading to death in one patient. The first case occurred in an 81-year-old ASA II woman scheduled for emergency abdominal surgery. Severe hypotension and tachycardia were observed after rocuronium, without bronchospasm. Neosynephrine allowed rapid resuscitation, and the patient recovered fully. The second patient was a 64-year-old ASA II man scheduled for abdominal surgery. Severe haemodynamic instability and bronchospasm occurred after rocuronium. Despite immediate life support, the postoperative period was complicated by persistent low systolic pressure, acute respiratory distress syndrome, acute renal failure, disseminated intravascular coagulation and pancreatitis, leading to the death of the patient.
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PMID:Anaphylaxis to rocuronium. 1256 31


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