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

Two cases of spontaneous atheromatous embolization associated with unusual complications are presented. One is an 85-year-old man who developed an acute abdomen and underwent a surgical resection of totally infarcted left-sided colon. Histologically, multiple acute atheromatous emboli were found occluding the serosal and pericolic mesenteric arteries causing transmural necrosis of the involved portion of bowel. The other is an 80-year-old woman who had had a coronary heart disease, hypertension, and renal insufficiency, and terminally developed a rapid deterioration of renal function and melena. Postmortem examination showed a severely, ulcerated, aortic atherosclerosis and widespread, recurrent, atheromatous emboli in many abdominal organs with the resultant severe nephrosclerosis, gastrointestinal mucosal hemorrhagic necrosis, and multiple infarcts in the pancreas and spleen. In addition, there was focal cortical necrosis of the kidneys accompanied with glomerular capillary fibrin thrombi indicating disseminated intravascular coagulation (DIC). These findings seen in the present two cases were briefly discussed in light of the previous pertinent literature.
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PMID:Atheromatous embolization. Report of two cases with unusual complications. 650 92

Abruptio placentae is a rather frequent syndrome in overseas countries. Leading to foetus death most of the time, it often endangers prognosis for the mother's life. Serious complications may be found such as shock due to hypovolaemia, coagulopathy among which process of disseminated intravascular coagulation prevail, organic renal insufficiency that may become unrecoverable because of the cortical atrophy of the kidney. The treatment combines obstetrical means with medical ones. Spontaneous uterine voiding will be tried for, since caesarian operation, often unavoidable, is not free from complication. Rehydration will be carried out by transfusing fresh blood and unfrozen plasma, the amount of which often enormous has to be dealt out in accordance with the central venous pressure.
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PMID:[Retroplacental hematoma overseas]. 685 27

Forty-four cases of acute necrotic haemorrhagic pancreatitis are studied. Fourteen cases were treated medically by peritoneal dialysis, 20 were treated surgically of which 16 had been medically treated by peritoneal dialysis. Fifteen died or 34%. Forty-one patients, 93.1% presented 8 major complications on admission and 2 complications were observed during the course of medical treatment (pulmonary shock and high digestive haemorrhage). The post surgical complications are excluded from this study. We report in order of frequency; effusion of the large peritoneal cavity (37 cases : 84%), hypocalcaemia less than or equal to 8 mg% (21 cases : 47.7%), renal insufficiency defined by a creatinaemia greater than or equal 2 mg% (17 cases : 38.6%), state of shock (13 cases : 29.5%), severe neurological disorders (11 cases : 25%), peritoneal haemorrhage (3 cases : 4.5%), disseminated intravascular coagulation (1 case : 2.2%), acute rabdomyolysis (1 case : 2.2%). Certain cases are particularly derogatory : pulmonary shock : 2 cases -- 2 deaths (100%); hypocalcaemia less than or equal to 7 mg/ : 6 cases -- 5 deaths (83.3%); acute tubular necrosis : 8 cases -- 6 deaths (75%); hypocalcaemia less than or equal 8 mg% : 21 cases -- 12 deaths (57.1%); high digestive haemorrhage : 3 cases -- 1 death (33.3%); amber known brown peritoneal effusion : 27 cases -- 12 deaths (44.4%); shock : 13 cases -- 5 deaths (38.5%). When in the same patients, less than 3 complications were present, the mortality rate was 20.8%. If more than 3 signs were observed the mortality rate rose to 53.3%. Except for pulmonary shock, six major complications were needed to give 100% mortality rate.
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PMID:[Acute necrotic hemorrhagic pancreatitis. Major complications (author's transl)]. 697 50

Clinical features and specific aspects of treatment were evaluated in 612 patients with gram-negative bacteremia observed over a 10 year period. Coagulation abnormalities or thrombocytopenia were observed in 64 per cent of the patients. Evidence of disseminated intravascular coagulation (DIC) was found in approximately 10 per cent of them but was of sufficient severity to be associated with subcutaneous or visceral bleeding in 3 per cent of them. The frequency of coagulation abnormalities, other than DIC, was greater in patients with more severe underlying disease but DIC occurred with similar frequency irrespective of the severity of underyling host disease. Coagulation abnormalities of all types were associated with increased fatality rates. Hypothermia was noted in 13 per cent of the patients at the onset of bacteremia but was transient and was not associated with increased fatality. Failure to mount a febrile response greater than 99.6 degrees F within the first 24 hours of bacteremia was associated with a significant increase in fatality rates. Prior corticosteroid therapy diminished the febrile response to bacteremia. Age, underlying host disease, granulocytopenia, congestive heart failure, diabetes mellitus, renal insufficiency, nosocomial infections, and antecedent treatment with antibiotics, corticosteroids, and antimetabolites significantly increased fatality rates. Appropriate antibiotic treatment reduced the fatality rate of those with bacteremia by approximately one-half among patients in each category of severity of underlying host disease. In addition, it was shown that early appropriate antibiotic therapy also reduced the frequency with which shock developed by one half. Even after development of shock, appropriate antibiotic therapy significantly reduced fatality rates. The use of combinations of antibiotics could not be demonstrated to significantly improve survival rates. Minimal differences in therapeutic efficacy could be demonstrated between individual antibiotics and various combinations of antimicrobials. Shock occurred in approximately 40 per cent of the patients and its frequency was not influenced by the species of etiologic agent. Contrary to previous reports, corticosteroid therapy in patients with shock did not enhance survival and treatment with an average of 4.0 g/day of hydrocortisone or its equivalents was associated with a significant increase in fatality rates.
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PMID:Gram-negative bacteremia. IV. Re-evaluation of clinical features and treatment in 612 patients. 698 71

Haemodialysis had become impossible or possible only using high doses of heparin in 20 patients with dialysis-dependent renal insufficiency due to lowering of antithrombin III (AT III). In order to assess the value of AT III substitution for effective heparin treatment and concomitant diminution of the danger of haemorrhage AT III substitution was done in these patients. Six patients. Six patients with acute renal failure and disseminated intravascular coagulation were able to undergo dialysis using only 750-1000 IU heparin/h after normalisation of AT III without complications. In 3 patients thrombosing of the extracorporeal system had occurred despite increasing doses of heparin; only after 1500 U AT III subsequent haemodialysis could be performed without thromboses. Dialysis was performed with continuous substitution of the AT III-heparin-complex in 6 patients prone to haemorrhage. 250-500 U of AT III-heparin-complex were sufficient and proved as safe and well manageable possibility of minimal anticoagulation. In 5 patients repeated thrombosing of the haemofilter per day had occurred during continuous arteriovenous haemofiltration. After AT III administration haemofilters could be left in situ for 18-46 hours.
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PMID:[Antithrombin III substitution in dialysis-dependent renal insufficiency]. 714 May 68

A snake bite may quite frequently lead to haemorrhagic symptoms ranging from hypofibrinogenaemia to disseminated intravascular coagulation. In rare cases acute renal insufficiency associated with tubular necrosis may occur due to a direct toxic lesion, shock symptoms or DIC. However, it is extremely rare that glomerulonephritis results from a snake bite. A thirteen-year-old girl develops gross haematuria, albuminuria and cylindruria without any shock symptoms two days after having been bitten by a European viper. Coagulation state and complement show slight changes, and the histological examination reveals proliferative nephritis with deposition of immune complexes. The clinical picture corresponds to recurrent haematuria; renal function is normal after follow-ups over a one-year-period.
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PMID:[Glomerulonephritis following snake bite]. 737 18

The purpose of this pilot study was to determine the effect of recombinant hirudin (r-hirudin) on coagulopathy and the relationship between concentrations of thrombin-antithrombin III (ATIII) complex (TAT) and thrombin-hirudin complex (THC) in patients with disseminated intravascular coagulation (DIC). Five patients with haematological malignancy associated with DIC were studied. r-Hirudin was administered by continuous intravenous infusion at a dose of 0.005 mg/kg/h for 4-9 days to each patient. Fibrin/fibrinogen degradation products (FDP), D-dimer, TAT and plasmin-alpha 2 antiplasmin complex (PAP) concentrations decreased after treatment with r-hirudin in four patients studied. However, in one patient, serum creatinine increased to 1.7 mg/dl and aPTT was prolonged to 74.4s. Statistical analysis disclosed significant positive correlations between plasma concentrations of hirudin and THC, and between concentrations of THC and TAT. The concentrations of THC were much higher than those of TAT. In conclusion, these findings indicate that r-hirudin more strongly inhibited thrombin than did ATIII without heparin, and that administration of r-hirudin to renal insufficiency required individual adjustment of dosage. The present findings also suggest that r-hirudin can be considered a new agent for the treatment of DIC.
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PMID:Recombinant hirudin for the treatment of disseminated intravascular coagulation in patients with haematological malignancy. 754 Aug 78

We describe the case of a 25-year-old woman who presented with the antiphospholipid antibody syndrome (APS) manifesting as hemolytic anemia, thrombocytopenia, renal insufficiency, thromboses in multiple sites including skin, spleen and nasal mucosa, and multiple sites of avascular necrosis of bone. Interestingly, she also had low grade disseminated intravascular coagulation, which has been suggested to be a mechanism for avascular necrosis. We suggest that the APS may be one cause of thrombosis in avascular necrosis.
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PMID:Catastrophic antiphospholipid antibody syndrome presenting with multiple thromboses and sites of avascular necrosis. 769 46

As a means of limiting homologous transfusions, many centers are using autotransfusion devices during the postoperative period. Although their use may limit the risks associated with homologous blood administration, various adverse effects have been reported including sepsis, disseminated intravascular coagulation, and renal insufficiency. The authors present the case of a 9-year-old girl who developed acute cardiorespiratory dysfunction after reinfusion of salvaged blood. The use of autotransfusion devices and the probable mechanisms responsible for adverse effects are discussed.
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PMID:Complications of autotransfusion with salvaged blood. 779 32

Since numerous pathogenic factors are known to be involved in the development of disseminated intravascular coagulation (DIC) and multiple organ failure (MOF) in sepsis, the successful management of these clinical states is difficult. To investigate the mechanisms further, we developed experimental sepsis models associated with DIC and MOF, or endotoxin induced renal insufficiency model unaffected by prerenal factors. The hypercoagulable state leading to DIC is considered to be a prerequisite for MOF and inactivation of Xa or suppression of platelet activation is an important step to prevent the occurrence of DIC and MOF.
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PMID:[Treatment of multiple organ failure]. 838 81


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