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

This study refers to the clinical features of 11 cases of hemorrhagic fever with renal syndrome (HFRS) which was prevalent in Nagoya City University Medical School. The clinical course was divided into two parts: the febrile stage and the polyuria stage. Symptoms such as lumbago, muscular pain, general malaise and anorexia disappeared along with a fall of fever. The incubation period of this disease was estimated to be about three weeks. Polyuria, proteinuria, gastric complication and impairment of liver function seemed to be some of clinical features of this disease. There was no HFRS patient with severe renal failure in our cases. The presence of disseminated intravascular coagulation (DIC) was confirmed in 3 of these 11 cases. Therefore, it was suggested that hemorrhagic tendency of this disease might be attributed to DIC. From our experiences, the most important factor for the treatment of the severe case was the earliest detection whether they were complicated by DIC or not. If they were suspected of DIC, it could be necessary to start treatment for DIC as soon as possible. Prophylactic measures for HFRS in our animal facility could contribute to the prevention of this disease.
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PMID:Clinical studies on hemorrhagic fever with renal syndrome found in Nagoya City University Medical School. 168 5

A case of extensive bone marrow necrosis due to cancer metastasis is reported. A 55-year-old female, who had a history of subtotal gastrectomy for signet ring cell carcinoma of the stomach 7 years ago, was admitted to our hospital with a complaint of lumbago on October 25, 1987. Red blood cell count was 92 X 10(4)/microliters, hemoglobin 2.7 g/dl, hematocrit 8.0%, platelet 6.4 X 10(4)/microliters, and white blood cell count 13,400/microliters with leukoerythroblastosis. Bone marrow aspiration of the sternum, left iliac crest, and bilateral posterior superior iliac supine showed extensive bone marrow necrosis. Serum ALP was increased to 7410IU/l, dominated isozyme of bone type. Hemostatic findings suggested a complication of consumption coagulopathy. Skull, vertebrae, iliac and pelvic bone X-ray showed multiple osteolytic lesions, and irregular isotope uptake was recognized on the bone scintigraphy using 99mTc. Sixth bone marrow examination at the right iliac crest revealed signet ring cell carcinoma metastasis. In spite of detailed examinations, there was no evidence of primary carcinoma, including the remnant of stomach. We speculated that the signet ring cells were originated from the respected gastric cancer. The patient has received anti-cancer chemotherapy with UFT and OK432, and is still alive 9 months after diagnosis.
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PMID:[Extensive bone marrow necrosis associated with carcinomatosis 7 years after operation for gastric cancer]. 254 85

Localized suppuration involving the spinal cord is uncommon. A case of spinal subdural empyema is reported. The patient is 54-year-old male who had been suffering a diabetes mellitus but did not receive any treatment. His initial symptom was lumbago. Then he noticed a palpitation and general malaise which made him visit a hospital. Because he did not show any improvement by a fluid therapy, he was transferred to our institute for the further evaluation. On admission, physical examination showed no abnormality. Blood pressure was 170/90 mmHg, heart rate 128/min. and body temperature 37.1 degrees C suggesting a septic shock state. Neurological examination revealed slight consciousness disturbance, mild tetraparesis and bilateral hypesthesia lower than the level of L3. Laboratory examination showed the elevated leukocyte count and fasting blood sugar and urine ketone body levels of 20,500/mm3, 257 mg/dl and 226 mg/dl respectively. Blood culture proved a septicemia of Streptococcus agalactiae afterwards. On the second day of admission, lumbar puncture revealed a purulent cerebrospinal fluid, though X-ray CT of lumbar spine did not confirm a diagnosis. Spinal magnetic resonance imaging (MRI) revealed a widespread abnormal intensity of the spinal canal from the level of Th11 to L4. On the T1-weighted image (TR 300 msec., TE 40 msec.), cerebrospinal fluid space was abnormally isointense. On the T2-weighted image (TR 2,000 msec., TE 80 msec.), subdural and cerebrospinal space was filled with an abnormal high-intense lesion especially on the ventral side. He developed semicoma due to hydrocephalus following a intraventricular empyema. He was also complicated disseminated intravascular coagulation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Spinal subdural empyema diagnosed by MRI and recovered by conservative treatment]. 257 46

We described here a seventy-one year-old male, who had repeated disseminated intravascular coagulation related to atherosclerosis and aneurysm of the aorta, and was successfully treated with self-subcutaneous injection of heparin sodium. He developed gingival bleeding and purpura in 1977. He was first treated with prednisolone (30 mg/day) and ACTH-Z under the diagnosis of idiopathic thrombocytopenic purpura associated with chronic thyroiditis, since platelet count (0.2 x 10(4)/microliters) was markedly decreased and megakaryocytes in the bone marrow were increased. By the treatment, platelet count recovered to 16.7 x 10(4)/microliters, while fibrin-degradation product levels were increased and hypofibrinogenemia developed, suggesting disseminated intravascular coagulopathy. Additional treatment with heparin was effective, and the coagulation studies became normal. In 1980, he again developed the episode with thrombocytopenia. At this time, prednisolone did not improve the episode, but heparin was effective. Since 1983, an enlargement of abdominal aorta had been recognized and gradually progressed. In 1983, he developed lumbago and abdominal pain, and received an emergency operation using artificial Y-graft vessel under the diagnosis of rupture of the aneurysm. There was no evidence of consumption coagulopathy at that time. He had been well until 1987, when he developed the third episode of thrombocytopenia with gingival bleeding. Thrombocytopenia was controlled with the treatment of heparin, but needed a continuous treatment with heparin. Thereafter, he has been well managed with self-injection of the anticoagulant, heparin sodium.
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PMID:[Disseminated intravascular coagulation related to atherosclerosis and aneurysm of aorta: successful management with subcutaneous self injection of heparin sodium]. 259 49

Five cases of gastric carcinoma (one woman) were investigated. The average age of the patients was 44 and the clinical manifestation were lumbago, melena and fatigue. Two cases were Borrmann III, and other were Borrmann IV, IIc and IIc advanced, respectively. Three were signet-ring cell carcinoma and the other two were moderately differentiated and well-differentiated adenocarcinoma, respectively. All patients showed leukoerythroblastosis. Bone marrow specimens revealed myelofibrosis in three cases, while adenocarcinoma cells were also found in three. MHA or DIC was found in three patients, all of whom died of bleeding tendency. Mean survival time was 2.6 months. Thus, bone marrow carcinomatosis proved to be very severe.
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PMID:[Clinicopathological studies on disseminated carcinomatosis of the bone marrow occurring through metastasis of gastric carcinoma]. 299 95

A case of advanced gastric cancer associated with metastatic carcinomatosis of the bone marrow, microangiopathic hemolytic anemia (MAHA) and disseminated intravascular coagulation (DIC) was reported. A 71-year-old woman complained of lumbago and general fatigue. At the time of admission, besides anemia, jaundice and a tendency to bleeding, the laboratory data showed, hyperbilirubinemia, elevated FDP and hemolytic anemia with fragmented red cells. The bone marrow was infiltrated by carcinoma, and an upper GI series examination showed Borrmann II type gastric cancer on the greater curvature of the antrum. After remission of both MAHA and DIC by mitomycin C, neothramycin and FOY, the patient successfully underwent subtotal gastrectomy. However, she died of cerebral hemorrhage on the 96th postoperative day.
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PMID:[Microangiopathic hemolytic anemia associated with gastric cancer]. 309 84

Endoscopic examination of a 35-year-old patient complaining of tarry stool, palpitation and lumbago led to a diagnosis of gastric cancer of Borrmann type 4. Laboratory data and bone scintigraphy revealed findings of DIC and multiple bone metastasis. He was treated with continuous intravenous infusion of FOY, but laboratory data with DIC went from bad to worse. It was considered that resection of the tumor was effective for DIC, then total gastrectomy and partial transverse colonectomy were performed, and the patient recovered from DIC. For the multiple bone metastasis, he received chemotherapy using cisplatinum and mitomycin C, and subsequent bone scintigraphy showed a dramatic improvement. Doxorubicin and 5-fluorouracil controlled peritoneal dissemination of the cancer.
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PMID:[Advanced gastric cancer with DIC and multiple bone metastasis treated with surgical resection and chemotherapy]. 310 31

A patient with multiple myeloma (IgG, k) associated with hypertetraploid chromosomal abnormality is reported. The patient was a 62-year-old female. She was admitted to our clinic in October 6, 1982 because of lumbago and a supraorbital subcutaneous tumor. Cellulose acetate membrane electrophoresis of her serum disclosed a M-protein in the gamma-globulin, and immunoelectrophoresis showed monoclonal IgG, k type. A marrow aspirate of her sternum contained 15% myeloma cells, some of which were large, while others were atypical. A chromosomal analysis of her bone marrow revealed 34 hypertetraploid cells of 35 metaphase cells. Chemotherapy was administered without success and she died of DIC and uremia on November 11, 1982. Histologically, pleomorphic myeloma cells that contained large cells with atypical nuclei proliferated in her bone marrow.
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PMID:[A case of multiple myeloma (IgG, k) associated with hypertetraploid chromosomal abnormality]. 312 34

This paper reports a case of TSS complicated with SSSS in an adult with liver cirrhosis. A 52-year-old male, heavy drinker, was referred to our clinic complaining lumbago and painful swelling of the right arm. The patient had peeling of the skin over the hips, knees and elbows with positive Nikolsky's sign. The patient was in a state of shock on admission. Pyrexia persisted for 4 days and finally the body temperature rose up to 39 degrees C. The laboratory studies revealed hypoxia, DIC and multiple organ failure, and these became progressively worse. He died 4 days after admission. According to the criteria, he was diagnosed as TSS, and TSST-1 was detected from his serum. Staphylococcus aureus, coagulase type V was cultured both from the blood and from the wound of his right middle finger. This isolated strain did not produce TSST-1. The skin specimen at autopsy showed that the cleavage plane lied at the subcorneal region and close to the granular layer, with specific changes caused by exfoliative toxin. It was compatible to the exfoliation which was caused by exfoliative toxin produced from the S. aureus coagulase type V. The autopsy also revealed alcohol liver injury, liver cirrhosis and multiple organ failure due to shock state. SSSS is rare in adults, to our knowledge this is the first reported case of TTS complicated with SSSS.
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PMID:[A case of TSS complicated with SSSS in an adult with liver cirrhosis]. 782 11

Magnetic resonance (MR) of bone marrow was studied in two cases of acute leukemia which showed bone marrow necrosis. Case 1:A 24-year-old female was admitted because of sternum pain and bleeding tendency. She was diagnosed AML based on the peripheral blood picture. Bone marrow biopsy revealed the presence of bone marrow necrosis. T1 weighted imaging of MR showed low signal intensity in all vertebral marrow. Fatty marrow was demonstrated after achieving complete remission and the MR imaging of bone marrow changed to show high intensity, suggesting fat deposition. Case 2: A 19-year-old female suffered from chest pain and lumbago, and was diagnosed as ALL. DIC and bone marrow necrosis were confirmed during chemotherapy for remission induction. T1 weighted imaging showed the mosaic pattern of low and high signal intensity. She achieved complete remission and bone marrow clot revealed the presence of fatty marrow. Most areas of low signal intensity of T1 weighted imaging changed to those of high signal intensity. These observations suggest that necrotized bone marrow seemed to change to fatty marrow along with achieving remission. MR imaging study of bone marrow is useful for evaluating hematopoiesis in hematologic disorders.
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PMID:[Magnetic resonance imaging (MRI) of bone marrow necrosis]. 786 14


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