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)

Two cases of acute promyelocytic leukemia (APL) treated with all-trans retinoic acid (ATRA) developed fever, dyspnea and chest pain. A chest roentgenogram showed bilateral pleural effusion (case 1) and bilateral interstitial infiltration (case 2). The first case was a 50-year-old female in her first relapse, who was initially diagnosed as having pleuritis tuberculosa and was treated with anti-tuberculotic agents. Her symptoms continued for 44 days and complete remission was achieved 53 days after commencing ATRA therapy. The second case was a previously untreated 46-year-old male. His case had been diagnosed as adult respiratory distress syndrome and he had been treated with prednisolone. His symptoms rapidly improved and complete remission was achieved 38 days after the ATRA therapy. This was the first report of patients in Japan considered to have developed "retinoic acid syndrome (RAS)". In our five APL cases treated with ATRA, the syndrome was not always accompanied by peripheral blood leukocytosis even though the two cases with RAS showed higher leukocyte counts than the other two cases without RAS and also had DIC. We should pay attention to the severe respiratory symptoms that develop in APL patients after ATRA treatment and immediate steroid therapy is required for such patients.
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PMID:[A "retinoic acid syndrome" observed in two cases of acute promyelocytic leukemia]. 823 Jul 49

We experienced two cases of descending necrotizing mediastinitis with different etiology. Case 1: A 59-year-old woman presented with chief complaints of dyspnea and swallowing disturbance. She had been diagnosed as having tonsillitis one week before. She was very pyrexic, and laboratory examination indicated acute inflammation. Chest X-ray and CT-scan showed enlargement of the mediastinum and pleural effusion. We diagnosed the mediastinitis to be a complication of tonsillitis. Case 2: A 54-year-old man had a tooth extracted 3 weeks prior to admission. His chief complaints were craniomandibular disturbance and neck swelling. Laboratory examination disclosed multiple organ failure and DIC. Chest X-ray and CT-scan showed enlargement of the mediastinum and pleural effusion. We diagnosed the mediastinitis in this case to be a consequence of an odontogenic infection following tooth extraction. Both patients received continuous drainage and irrigation of the abscesses and recovered in about 2 months. Case 1 showed an impaired glucose tolerance after recovery from mediastinitis. Although the main causes of mediastinitis are cardiac surgery and esophageal perforation, our cases demonstrate that mediastinitis may occur as a complication of deep neck infection.
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PMID:[Two cases of mediastinitis as a complication of odontogenic infection and tonsillitis]. 834 9

As long-term survival has become possible in patients with autosomal dominant polycystic kidney disease (ADPKD) with progress in hemodialysis (HD), complications by various extrarenal diseases has presented new problems. Recent experience of two rare cases of ADPKD ending fatally due to complications by polycystic liver is presented. Case 1: A 60-year-old female with a family history of ADPKD without a past history of liver disease, was diagnosed as ADPKD at the age of 45 years. Hemodialysis was started at the age of 58 years. From 6 months prior to her death, abdominal circumference increased (body height: 149 cm, abdominal circumference: 100 cm). Dyspnea, abdominal pain and anorexia appeared and she died of hepatic failure leading to cachexia. Case 2: A 76-year-old female with a family history of ADPKD without a past history of liver disease, was started on HD at the age of 73 years. Abdominal circumference was 84 cm (body height: 138 cm). She was repeatedly admitted to and discharged from the hospital due to febrile episodes. Infection of polycystic liver was complicated by DIC and she died of gastrointestinal hemorrhage. Autopsy revealed abscess in some of the cysts in the liver. Hepatic cysts most frequently complicating ADPKD so far have presented with scarcely any clinical problems. Recently, however, cases of infection of hepatic cysts, portal hypertension and hepatic insufficiency have been reported. The relationship between these hepatic diseases and the prognosis of ADPKD has received attention. Increase in the number of cases of complications similar to the present cases is anticipated.
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PMID:[Two cases of autosomal dominant polycystic kidney disease treated with hemodialysis associated with polycystic liver complications related to the cause of death]. 875 71

Thirty-nine Danish cases of Capnocytophaga canimorsus septicemia were reviewed to determine the clinical course of this infection. The cases of septicemia were related to recent dog bites or other close contact with dogs. The period from the bite to the onset of symptoms ranged from 1 to 8 days. The mean age of the patients was 59.1 years (range, 28-83 years). Underlying conditions included previous splenectomy and alcoholism. Thirteen patients had previously been in good health. Common initial symptoms were fever, malaise, myalgia, vomiting, diarrhea, abdominal pain, dyspnea, confusion, headache and skin manifestations. Disseminated intravascular coagulation developed in 14 patients, meningitis in 5, and endocarditis in 1. Twelve of the patients died. All patients except two were treated with penicillin or ampicillin. Five patients had received antibiotics prior to admission. Attention should be drawn to C. canimorsus septicemia in cases of febrile illness following dog bites or contact with dogs, as well as those involving previously healthy persons. The incidence of this condition in Denmark is estimated to be 0.5 case per 1 million people per year.
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PMID:Capnocytophaga canimorsus septicemia in Denmark, 1982-1995: review of 39 cases. 881 32

A 61-year-old man with a history of hypertension and diabetes mellitus had a tooth extracted. Nine days later, he was admitted to the hospital with complaints of high fever, dyspnea, and anterior chest pain. Physical examination revealed a drowsy man with a fever of 38.2 degrees C, blood pressure of 66/44 mmHg, and marked redness and swelling from the neck to anterior part of the chest. Laboratory examination indicated severe infection and multiple organ failure, consisting of cardiac, respiratory, renal, and hepatic failure, with disseminated intravascular coagulation. Chest X-ray and CT-scan films showed abscesses extending from the neck to the mediastinum, and bilateral pleural effusion. Immediately, he was treated with catecholamines, furosemide, mechanical ventilation with a high concentration of oxygen, continuous drainage, repeated skin incisions, and broad-spectrum antibiotics. In addition, steroid pulse therapy was administered for persistent respiratory failure. On the 28th hospital day, a fistula developed between the trachea and the mediastinum, and an intratracheal tube had to be inserted through the fistula. On the 212 th hospital day, after intravenous hyperalimentation, continuous intravenous insulin infusion, and administration of broad-spectrum antibiotics, catecholamines, and furosemide, the patient was weaned from mechanical ventilation. A restrictive ventilatory defect due to ankylosis and atrophy of underused muscles was noted after weaning, but the PaO2 was high with a low dose of oxygen (1 to 2 l/min), and 21 months later, the blood gases were normal while the patient was breathing room air. As of January, 1996, he was undergoing rehabilitation to promote his recovery from ankylosis, muscle atrophy, and speech dysfunction.
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PMID:[Recovery from descending necrotizing mediastinitis and multiple organic failure after seven months of mechanical ventilation]. 893 49

A 52-year-old woman visited a physician on Oct. 17, 1995 because of dizziness, general fatigue and a slight fever. A Chest X-ray film showed micronodulous and infiltrative shadows in the bilateral upper lung fields. Liver dysfunction was also recognized. As dyspnea and hypoxemia progressed very rapidly, the patient was intubated and kept under mechanical ventilation. A diagnosis of miliary tuberculosis with adult respiratory distress syndrome (ARDS) was made based on the detection of acid-fast bacilli from sputum obtained from the endotracheal tube. She was admitted to our hospital on Oct. 24, 1995 receiving anti-tuberculous drugs combined with high-dose methylprednisolone. As disseminated intravascular coagulation (DIC) and acute pancreatitis also developed, gabexate mesilate was added to the preceding therapy. This combination therapy was effective and the patient gradually improved. Two months after the admission, aneurysms of the abdominal aorta and left renal artery were discovered. As the size of the aneurysms had been increasing along with abdominal and low back pain, the patient was transferred to an other hospital for surgical treatment. She underwent a successful operation for pseudoaneurysms, the etiology of which was tuberculosis according to pathological findings and detection of acid-fast bacilli from the resected specimens. This is the 10th case of tuberculous aneurysm of the aorta which was successfully operated on in Japan. ARDS, DIC and aneurysm occur rarely as complications of miliary tuberculosis, but they are life-threatening, and lead to a serious prognosis if untreated. Early diagnosis of miliary tuberculosis and tuberculous aneurysm is very important for a good outcome.
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PMID:[A successfully treated case of miliary tuberculosis with adult respiratory distress syndrome and tuberculous aneurysm of abdominal aorta]. 969 83

We present a rare case of chronic active Epstein-Barr virus (EBV) infection showing various clinical outcomes. A 26-year-old man was admitted to our hospital due to persistent fever and dyspnea. Serologic response of the patient to EBV indicated chronic active infection. He showed pleuritis, parotitis, chronic hepatic dysfunction, disseminated intravascular coagulation, virus associated hemophaghocytic syndrome, acute rhabdomyolysis, acute renal failure, acute cerebellar ataxia, encephalitis and multiple brain abscesses. None of acyclovir, gancyclovir, prednisolone or interleukin-2 was effectual to abolish those abnormalities. This is the first report of transient cerebellar ataxia which aggravated to panencephalitis associated with chronic EBV infection.
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PMID:Severe chronic active Epstein-Barr virus infection accompanied by virus-associated hemophagocytic syndrome, cerebellar ataxia and encephalitis. 976 97

A 42-year-old man was admitted because of fever, productive cough, and progressive dyspnea. Chest x-ray films and computed tomographic scans disclosed dense consolidation in the left and right lung fields. No pathogenic agent was found despite extensive bacteriological examinations. Based on serological findings, the patient was given a diagnosis of acute pneumonia caused by Legionella micdadei. It has been reported that Legionnaire's disease is easily complicated by fatal systemic illnesses such as disseminated intravascular coagulation (DIC) and multiple organ failure. In fact, the patient suffered from severe hypotension and DIC on admission. Treatments against systemic complications were started together with intravenous administration of antibiotics including erythromycin. Continuous intravenous cathecolamin, however, failed to alleviate the patient's shock. We therefore applied endotoxin eliminating therapy using a polymyxin-B-column (PMX) and continuous hemofiltration (CHF). The patient recovered from critical shock immediately after the start of PMX, which together with CHF, alleviated his systemic complications. Although the factors responsible for fatal systemic complications in Legionnare's disease are not well-documented, our findings suggested that some substances removable by PMX and CHF play an important role in pathogenesis.
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PMID:[Severe Legionella micdadei pneumonia effectively treated with hemofiltration therapy]. 989 32

A late phase II clinical study of RP56976 (docetaxel), a new anticancer agent for advanced/recurrent head and neck cancer, was conducted in 29 institutions all over Japan as a multi-institutional cooperative study. Docetaxel was administered by 1 to 2-hour intravenous infusion at a dose of 60 mg/m2 every 3 to 4 weeks. Of 63 patients eligible in this study, 59 were judged as complete cases. Complete response (CR) was observed in 1 patient, partial response (PR) in 13, no change (NC) in 25, and progressive disease (PD) in 20, for an overall response rate of 22.2% (14/63, 95% CI: 12.7-34.5%) in eligible cases, and 23.7% (14/59, 95% CI: 13.6-36.6%) in complete cases. Previously treated patients showed a 17.9% (10/56) response rate, whereas treatment--naive patients showed a 57.1% (4/7) response rate. Among 46 patients who received prior chemotherapy, one CR and 7 PR were observed with a 17.4% response rate. Major hematological toxicities were leucopenia in 95.1% (> or = grade 3, 59.7%) and neutropenia in 90.3% (> or = grade 3, 79.0%). Other severe toxicities (> or = grade 3) included anorexia in 9.7% (6 cases), diarrhea in 3.2% (2 cases), dyspnea in 3.2% (2 cases), and fatigue in 3.2% (2 cases). One patient had a grade 3 interstitial pneumonia; however, symptoms were resolved by the administration of corticosteroids. During this study, one patient died due to multiple organ failure (MOF) caused by disseminated intravascular coagulation (DIC), and this case was reported as a therapy-related death. Based on these results, docetaxel is an active agent for treatment of head and neck cancer.
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PMID:[Late phase II clinical study of RP56976 (docetaxel) in patients with advanced/recurrent head and neck cancer]. 998 6

A 72-year-old woman was admitted because of anorexia and dyspnea. She was given a diagnosis of pulmonary hemorrhage and renal failure. Despite treatment with high-dose steroid and hemodialysis, the patient died of disseminated intravascular coagulation on the 9th hospital day. Autopsy revealed intra-alveolar hemorrhage, crescentic glomerulonephritis, and systemic vasculitis with fibrinoid necrosis. A direct immunofluorescence study demonstrated linear deposition of IgG along the glomerular basement membrane (GBM). Both anti-GBM antibody and anti-neutrophil cytoplasmic antibody with perinuclear pattern (P-ANCA) were detected in the patient's serum by enzyme immunoassay. Goodpasture's syndrome with P-ANCA was diagnosed. There has been some controversy as to whether vasculitis occurs in patients with Goodpasture's syndrome. This was a rare example of well-documented Goodpasture's syndrome with P-ANCA and systemic vasculitis, the exact etiologic relationships among which remain to be clarified.
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PMID:[An autopsy case of Goodpasture's syndrome with P-ANCA and systemic vasculitis]. 1008 78


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