Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recently cases of tsutsugamushi disease have been reported in various areas in Japan. We met a case infected in a rural area, Sennan of Osaka prefecture. The patient suffered from high fever, left axillary lymphadenitis. At his left elbow an eschar was detected, so tsutsugamushi disease was suspected, despite no rash nor CRP elevation. By indirect immunofluorescence (IF) method, the diagnosis was confirmed. At an early stage (the fifth day after onset) he was followed by probable DIC, remitted successfully by administration of minocycline. For 20 years tsutsugamushi disease has not been reported in Osaka prefecture. This case is the second one and the first child case in Wakayama prefecture. Epidemiologic assessments may need to be investigated in Osaka and Wakayama Prefecture.
 ...
PMID:[The first case of tsutsugamushi disease in 20 years infected in a rural region of Osaka]. 251 27

We previously studied fibrinolysis and fibrinogenolysis by analyzing fragments of fibrin/fibrinogen degradation products (FDP) employing sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting. In this report, we characterized the fragments of FDP in three patients with increased serum FDP, that were caused by various diseases. In the patient suffering from tuberculous constrictive pericarditis (case 1), the most part of the FDP fragments were DD and D. In the patient suffering from infection in addition to liver cirrhosis (case 2), the most part of the FDP fragments were high molecular weight (HMW) and D. In case 1 and 2, serum FDP levels were increased in parallel with the elevations of CRP levels. Although DD and HMW fragments were remarkably increased in case 1 and 2 with our immunoblotting analysis, DD levels assayed with LPIA system were much lower than FDP levels. The reason this discrepancy was explained by the observation that affinities of the monoclonal antibody used in LPIA system with DD and HMW fragment were markedly lower than that to DD-E fragment. In the patient suffering from deep vein thrombosis probably caused by steroid therapy of nephrotic syndrome (case 3), the most part of detected FDP fragments were DD and HMW in the period when APTT was shorter than normal, whereas D was mainly observed in the period when APTT was normal. In case 3, FDP and DD levels were increased in parallel with the shortening of APTT. In these non-DIC patients, increased serum FDP levels were induced by the presence of ascites and/or pleural effusion plus infection.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Studies on the fragments of FDP in 3 non-DIC patients with increased FDP levels in the sera]. 836 Oct 25

We previously reported a study on fibrinolysis and fibrinogenolysis that analyzed fragments of fibrin/fibrinogen degradation products (FDP) using sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting. In this report, we characterized the fragments of FDP in three patients with disseminated intravascular coagulation (DIC) associating with acute promyelocytic leukemia (APL). D, Y, DD, DY/X and high molecular weight fragments were observed in sera of all the patients obtained at the onset of APL. These results showed that various degrees of fibrinogenolysis, concomitant with fibrinolysis, was occurring in APL patients presenting DIC. However, changes in the patterns of the FDP fragments during anticoagulation therapy were apparently different among three patients. Namely, fibrinogenolysis was dominant in case 1, while fibrinolysis was dominant in case 2. Interestingly, fibrinogenolysis and fibrinolysis were almost equivalent from the onset to the end of DIC in case 3. In case 3, FDP and FDP-D dimer were remarkably elevated about two months before the onset of APL, although their elevation was not complicated with DIC but with bone marrow necrosis. At that time, serum LDH levels and plasma polymorphonuclear elastase (PMN-Ela) were increased presumably due to the release of these enzymes from necrotic bone marrow, and the levels of CRP and plasma fibrinogen were increased probably due to an infectious complication. In non-DIC period of case 3, FDP and FDP-D dimer were spontaneously decreased without reduction of PMN-Ela levels, after three weeks of chemotherapy for microbial agents. Taken together, characteristics of FDP fragments were unique to each case of APL-DIC, probably because many factors differently affected the degradation of fibrin and/or fibrinogen.
 ...
PMID:[Studies on the fragments of FDP in 3 patients with DIC associated with acute promyelocytic leukemia]. 836 Oct 40

The patient was 69-year-old male. He has a history of treatment for tuberculosis by artificial pneumothorax about 47 years ago. He was admitted an another hospital under the diagnosis of tuberculous pyothorax. He was transferred to our hospital because of chest pain and fever. Laboratory findings on the admission were as follows: ESR was 120 mm/hr, CRP was 20.22 mg/dl and other data were almost within normal limits. Chest X-ray showed a massive shadow in the right lower lung field, adjacent to the chest wall. Computed tomography (CT) showed tumor shadow with low density and invasions into the adjacent chest wall. Histological examination of surgically excised tumor biopsy revealed malignant lymphoma. The patient's condition improved and the size of tumor decreased temporarily by chemotherapy. Then, he began to complain of chest pain and high fever, and tumor in the chest wall invaded into the whole chest wall. He died of disseminated intravascular coagulation despite continuing chemotherapy. Postmortem examination revealed the following findings : the tumor existed mainly in the parietal pleura or the chest wall, adjacent to the lesion of pyothorax, and immunohistochemical examination showed that tumor was malignant lymphoma, diffuse, large B-cell type. Recent studies have shown a close association between EBV infection and pyothorax-associated lymphoma. We have to keep in mind the possible development of malignant lymphoma following tuberculous pyothorax, when we see patients complaining of fever or chest pain with tuberculous pyothorax.
 ...
PMID:[A case of chronic tuberculous pyothorax associated malignant lymphoma]. 875 18

We experienced the perioperative management of a hemorrhagic shock associated with postpartum uterine rupture. After the emergency abdominal total hysterectomy, massive blood transfusion was required to maintain the hemodynamics and the laparotomy for hemostasis was performed on the 1st, 2nd and 7th ICU day. Total amount of transfused blood products was 37,000 ml during one week. The patient immediately developed DIC and acute renal failure. Laboratory data showed increased leukocyte count (the peak value was 56,100 microliters-1 on the 12th ICU day), and neutrophilic fraction was more than 90% of leucocyte. After the decrease in CRP, the decrease in total bilirubin concentration was delayed. There were no other signs of infection and no remarkable change in MOF score. There was a discrepancy between this leukocytosis and the severity of organ dysfunction, and the cause of the leukocytosis was unknown.
 ...
PMID:[A case of leukocytosis after massive blood transfusion for postpartum hemorrhagic shock]. 909 12

We found 5 cases of prostatic carcinoma with metastasis with alpha 2 macroglobulin (alpha 2 M) concentration below approximately 40 mg/dl in serum. All these patients had bone metastasis, and none of them had DIC. We found no other cases with such a low concentration of alpha 2 M. Their alpha 2 M level increased to normal level after treatment with transurethral resection of prostate or hormone agents, and the level was correlated with the clinical symptom. During the clinical course, their alpha 2 M level was negatively correlated with prostate-specific antigen (PSA) and prostatic acid phosphate (PAP). All these results suggest that alpha 2 M concentration in serum reflects the severity of prostatic carcinoma with metastasis and that alpha 2 M deficiency is an indicator of metastasis. The acute phase proteins of CRP and serum amyloid A did not increase in spite of the presence of metastasis in these patients with extremely low alpha 2 M level (< 20 mg/dl), suggesting that alpha 2 M is involved in the metabolism of these acute phase proteins. On immunohistochemical studies, their specimens of prostatic carcinoma gave positive stain for PSA and urokinase-type plasminogen activator (u-PA). Both PSA and u-PA formed a complex with alpha 2 M in vitro. The alpha 2 M deficiency in these patients might be due to the complex formation between alpha 2 M and these prostate-originated proteases and to the rapid disappearance of the complex.
 ...
PMID:[Studies on alpha 2 macroglobulin deficiency in association with cancer metastasis]. 910 63

We compared the severity of clinical symptoms and laboratory test results of tsutsugamushi disease patients in Oita Prefecture according to the serotype of infected R. tsutsugamushi. Of the 45 patients, except one with the Karp-type, who were suffering in Oita Prefecture between 1992 and 1994, 20 were the Irie-type and 24 were the Hirano-type. There was no apparent difference with regard to clinical symptoms between the two groups of patients. Laboratory tests showed that CRP increased almost equally in the two groups. The ESR level was slightly higher in the Irie-type patients than in the Hirano-type, but did not differ significantly between the two groups. Both leukocyte count in the acute stage and platelet count decreased in the Hirano-type, as compared with those of normal ranges in the Irie-type. GPT values elevated in proportion to the day of illness in the acute stage. This trend continued after the initiation of specific chemotherapy in the Hirano-type. The median GOT, GPT and LDH values were 71, 65 and 709 IU/l for the patients in the Hirano-type, as compared with 37, 36.5 and 546.5 for the patients in the Irie-type, respectively. Above results show that the Hirano-type rickettsiae produces a more severe illness than the Irie-type ricketsia. Platelet count had a significant correlation with ESR, suggesting the pathophysiologic changes leading to disseminated intravascular coagulation, a symptom of severe tsutsugamushi disease. There may be common causes in leukopenia and thrombopenia, as being suggested by the significant correlation between leukocyte count and platelet count.
 ...
PMID:[Analysis of clinical severity of tsutsugamushi disease according to the serotype of pathogenic rickettsia]. 916 83

Human parvovirus B19 (HPV-B19) has been known as the etiologic agents of erythema infectiosum in normal childhood, and chronic anemia and thrombocytopenia in immuno-compromised patients. Recently, this virus has been reported as the association with rheumatic manifestation such as rheumatoid arthritis and systemic lupus erythematosus (SLE). We described here a patient whose HPV-B19 infection was mimiking atypical symptoms of SLE at diagnosis, and was persistent because of immuno-suppressive therapy for SLE. A 34-year-old female was admitted to our hospital on 22 June 1995, presenting fever episode and cervical lymph node swelling. Before eighteen months, she was received methyl-predonisolone pulse therapy and plasma exchange by fresh frozen plasma for the treatment of Stevens-Johnson syndrome, and after several weeks these therapy she was suffered from viral infection with lymphadenopathies with a transient appearance of atypical lymphocytes in her peripheral blood smear. On laboratory examination at the present admission, her peripheral blood showed anemia, thrombocytopenia with atypical lymphocytes. Throughout her hospitalization, anti-nuclear antibody (ANA) suspected SLE including anti-DNA and anti-Sm antibody were all negative except of transient week positive ANA screening test. Her physical condition presented poor clinical course with fever elevation, increased ascites and renal dysfunction showing the elevation of CRP and circulating immune-complex (Clq binding method). Her serum was positive for IgM and IgG antibody against VP-1 and VP-2 antigen of HPV-B19 by ELISA in April 1996. And then, HPV-B19 DNA by polymerase chain reaction (PCR) was positive in bone marrow sample in March 1996, and also positive in spleen necropsy at death. We confirmed persistent chronic HPV-B19 infection by measurement of HPV-B19 IgM and IgG antibody by ELISA and HPV-B19 DNA by PCR. The plasmapheresis and administration of intravenous immunoglobulin showed the possible efficacy for her symptom throughout this clinical course. Moreover, bone marrow smear showed the finding of virus-associated hemophagocytic syndrome, and finally, she was died of cervical hemorrhage accompanied with disseminated intravascular coagulation syndrome on July 1996. HPV-B19 infection can present an atypical clinical picture that is highly suggestive of SLE. We suggest that the therapy of steroids and immuno-suppressive agents should be cautious, because these may potentially cause persistent chronic HPV-B19 infection and induced life-threatening clinical course.
 ...
PMID:[Human parvovirus B19 infection mimicking systemic lupus erythematosus: case report]. 931 Dec 85

This report describes a 12-year-old girl who developed vaccine-type pneumococcal septicemia (type 4, Danish nomenclature) 2 years after splenectomy for recurrent idiopathic thrombocytopenia despite vaccination with the 23-valent vaccine 4 weeks before surgery and antibiotic prophylaxis with penicillin V. The disease presented as high fever with shivering and vomiting followed by disseminated petechiae and a deteriorated general condition. Initial laboratory studies showed severe sepsis with leucocytopenia and thrombocytopenia, a markedly elevated CRP, and disseminated intravascular coagulation. Despite antibiotic treatment, which was initiated with clindamycin, cefotaxime and trimethoprim/sulfamethoxazole and was switched to cefotaxime and penicillin after the result of the blood culture had been obtained, the patient had to be ventilated, and hemofiltration became necessary because of acute renal insufficiency. Furthermore, she required amputation of all her toes because of severe necrosis. No type-specific pneumococcal antibody titers were detected during and after infection. It remains unclear whether the susceptibility to Streptococcus pneumoniae was due to primary failure of antibody production or a decline in antibody levels after vaccination. Patients and/or their relatives should be informed that neither vaccination nor continuous antibiotic prophylaxis can guarantee full protection against infection with S. pneumoniae in patients after splenectomy.
 ...
PMID:Overwhelming postsplenectomy infection with vaccine-type Streptococcus pneumoniae in a 12-year-old girl despite vaccination and antibiotic prophylaxis. 942 57

Legionellosis is an important cause of severe pneumonia in the community. Inadequate therapy will lead to respiratory distress syndrome, disseminated intravascular coagulation (DIC) and finally fatal multiple organ failure. We encountered a rare case in which early manifestation included septic shock and DIC complicated by acute myocardial infarction (AMI) suspected to be derived from Legionnaires' disease. A 54-year-old healthy female complained of lumbago, high fever and dry cough 10 days after visiting a hot spring spa. She was emmergently admitted due to shock. Physical examination demonstrated hypotension, high fever, course creakle in the right lower lung. Hepatosplenomegaly, lymphadenopathy and eruption were not found. WBC count was 34600/microliters with nuclear shift. CRP elevated. FDP, D dimer and TAT also elevated CPK elevated with dominance of the MB isozyme. Chest roentogenography revealed congestive heart failure, pleural effusion and obscure pneumonic shadow and EKG showed ST segment elevation in leads I, II, III, aVF, V4, V5, and V6. The patient was diagnosed as having septic shock, DIC and AMI. She was treated with gabexate mesilate, high dose methyl prednisolone and dopamine hydrochloride as well as piperacillin, meropenem, isepamycin and fluconzaole. Despite intensive care, the blood pressure fell again and pneumonia had progressed on the 8th hospital day. These antibiotics appeared to be ineffective. Erythromycin was then administered and a dramatic effect. was obtained as the patient recovered. Serum titer of Legionella pneumophila (serogroup 1) rose to 128-fold 2 weeks after the onset. Other serum titers such as Chlamydia psittaci, Rickettsia, Mycoplasma were all negative. Cultures obtained from the sputum, throat swab, urine and blood did not yield any microorganisms. Although the diagnosis could not be confirmed because the titer did not elevate over 256-fold of 4-fold within 2 weeks after the onset, Legionella infection was highly suspected from the clinical features. This is a rare case in which septic shock and DIC with AMI preceded pulmonary symptoms in a non-immunocompromised patient.
 ...
PMID:[Early manifestation of septic shock and disseminated intravascular coagulation complicated by acute myocardial infarction in a patient suspected of having Legionnaires' disease]. 958 3


1 2 3 Next >>