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Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Complement activation as shown by increased clearance of radioactive C1q and reduction in serum-C3 level was found in fifteen (83%) of eighteen patients studied during Plasmodium falciparum infection. Six patients had haemostatic defects suggesting disseminated intravascular coagulation (D.I.C.), and five others had other clinical complications. A correlation was found between reduction of C3 and clinical complications as well as with the degree of anaemia and with thrombocytopenia. Moreover, the most severe thrombocytopenia and the most severe reduction of C3 levels were found in those patients with D.I.C. An immune reaction associated with complement activation in P. falciparum infection is believed to contribute to injury of red blood-cells and platelets and to promote the development of D.I.C. and other serious clinical complications.
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PMID:Complement changes and disseminated intravascular coagulation in Plasmodium falciparum malaria. 4 1

This paper describes changes in the circulating platelets of 25 patients with acute malaria within 2 to 6 days of onset of illness. Thrombocytopenia was observed in 10 out of 15 patients with Plasmodium falciparum infection, and in 4 out of 9 patients with P. vivax infection. One patient with a mixed infection of both species had a disseminated intravascular coagulation. Platelet antibody was detected in the sera of 8 out of 11 cases by the complement lysis inhibition technique and indirect immunofluorescence. The mean platelet antibody concentrations in the sera of 11 patients and 53 control subjects were 122.70 +/- 80.25 ng/10(7) platelets and 36.69 +/- 18.72 ng/10(7) platelets, respectively. An inverse relationship between the platelet count and platelet antibody levels in serum supported the view that thrombocytopenia in malaria may be partly immune-mediated. Platelet aggregation responses to agonists such as ADP, adrenaline, collagen and ristocetin revealed hyperactivity. Ultrastructural study of unstimulated platelets from patients revealed several changes such as centralization of dense granules, glycogen depletion, and formation of pseudopods and microaggregates, indicating in vivo activation of the platelets, which may also lead to thrombocytopenia.
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PMID:Functional and ultrastructural changes of platelets in malarial infection. 306 47

Incidence of falciparum malaria in developed countries has increased in recent years due to tourism to tropical countries and immigration from Asia and Africa. In Switzerland, about 250 cases of malaria were reported in 1994 to the Federal Office of Health, including three cases with fatal outcome.1 The most commonly described complications of plasmodia infection are cerebral malaria, acute renal failure, and severe anemia with disseminated intravascular coagulation. However, pulmonary involvement occurs in 3 to 10% of cases and represents the most serious complication of this infection, with a lethality of 70%.2,3 Furthermore, a pronounced general immunosuppression has been reported in malaria patients, which may predispose them to opportunistic infections.4 We report a case of Plasmodium falciparum infection complicated by severe acute respiratory distress syndrome (ARDS) with development of systemic cytomegalovirus (CMV) infection leading to death. This evolution implies a severe immune deficiency associated with malaria, as previously suggested in the literature.
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PMID:Septic Shock due to Cytomegalovirus Infection in Acute Respiratory Distress Syndrome after Falciparum Malaria. 981 2

Jaundice is not an unusual accompaniment of malaria. It can occur due to intravascular hemolysis, disseminated intravascular coagulation, and, rarely, 'malarial hepatitis'. Although the primary schizogony of the malarial parasite always leads to the rupture of the infected hepatocyte, alteration of the hepatic functions is uncommonly recorded due to this event. Histologically, the hepatitis or the actual inflammation in the liver has never been demonstrated. Nonetheless, the term 'malarial hepatitis' (MH) has been used in the literature to describe the occurrence of hepatocellular jaundice in patients with Plasmodium falciparum infection. The authors' own data and review of the literature indicate that it is not an uncommon entity. In endemic areas, jaundice is seen in approximately 2.5% of patients with falciparum malaria. It also appears to be a heterogeneous syndrome and one can recognize two clinical subsets. In one group there was an acute, virulent presentation with coma, renal failure and in some cases even hemorrhagic manifestations. It is only in this setting that jaundice signified a 'severe' disease as noted by the World Health Organization action program. This presentation is often confused with acute viral hepatitis and acute hepatic failure in non-endemic areas, but can be clinically differentiated.
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PMID:Jaundice in malaria. 1610 16

Due to dramatic development of modern means of transport, exotic countries located on distant continents are today within a few-hour reach by a jet. Every year several million people travelled by air in business or as a tourists. This results in easy transmission of parasitic and infectious factors from continent to continent or from country to country. Plasmodium vivax infection: diagnosis concerned 6 men who had returned from Thailand, India, Senegal and Zaire. The parasitosis was detected as a result of thin smear of periferal blond tests - there were found P. vivax trophozoites an shizontes in erythrocytes. In the patients we found haematologic and termoregulation disturbances as well as hapepatosplenomegaly. Halfan was applied in therapy. Plasmodium falciparum infection: the infection was found in a man and a women after return from Kenya and Sudan. The parasitosis was detected as a result of thin smear of peripheral blond test - there found trophozoites of the parasite in erthorocytes. The course of malaria in the woman was very severe with cerebral malaria, DIC syndrome and blond circulation disturbances, hepatocellular and nephrocellular damage. Entamoeba histolytica, HAV and Candida albicans mixed infections: found in men who had returned from India. Severe E. histolytica infection: diagnosed in a women after return from Greece. There were found massive lesion of large intestine mucosa and high-degree disturbances. Leptospirosis icterohaemorrhagiae infection: found in a man after return from Belarus. Haematologic disturbance and hepatocellular and nephrocellular damage were observed.
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PMID:[Selected parasitic and infectious diseases in persons returning from the tropics]. 1688 51

Malaria remains a highly prevalent disease in more than 90 countries and accounts for at least 1 million deaths every year. Plasmodium falciparum infection is often associated with a procoagulant tonus characterized by thrombocytopenia and activation of the coagulation cascade and fibrinolytic system; however, bleeding and hemorrhage are uncommon events, suggesting that a compensated state of blood coagulation activation occurs in malaria. This article (i) reviews the literature related to blood coagulation and malaria in a historic perspective, (ii) describes basic mechanisms of coagulation, anticoagulation, and fibrinolysis, (iii) explains the laboratory changes in acute and compensated disseminated intravascular coagulation (DIC), (iv) discusses the implications of tissue factor (TF) expression in the endothelium of P. falciparum infected patients, and (v) emphasizes the procoagulant role of parasitized red blood cells (RBCs) and activated platelets in the pathogenesis of malaria. This article also presents the Tissue Factor Model (TFM) for malaria pathogenesis, which places TF as the interface between sequestration, endothelial cell (EC) activation, blood coagulation disorder, and inflammation often associated with the disease. The relevance of the coagulation-inflammation cycle for the multiorgan dysfunction and coma is discussed in the context of malaria pathogenesis.
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PMID:Blood coagulation, inflammation, and malaria. 1826 2

Symmetric peripheral gangrene is rare and relatively uncommon complication of malaria. We report a case of a 50-year-old male who survived Plasmodium falciparum infection with disseminated intravascular coagulation. Symmetric peripheral gangrene in our case, which ultimately required amputation of the toes, was most likely due to interaction between parasitic factors and host factors.
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PMID:Symmetrical peripheral gangrene with Plasmodium falciparum malaria. 2363 80