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)

The maternal mortality rate associated with eclampsia ranges from 100 to 6000 per 100,000, and the perinatal mortality rate ranges from 150 to 400 per 1000. Both eclampsia and its preceding condition, pregnancy-induced hypertension, occur in varying degrees in different parts of India. The warning signs of imminent eclampsia are 1) systolic blood pressure of 160 mmHg or more on two occasions six hours apart when the patient is on bed rest; 2) proteinuria of 5 g or more in 24 hours or 3 + or more by semiquantitative assay; 3) oliguria or anuria; 4) cerebral or visual disturbances; 5) pulmonary edema or cyanosis; and 6) epigastric/right hypochondriac pain, impaired liver function, and thrombocytopenia and coagulation disorders. Eclampsia is classified as the acute fulminating type, which can occur without warning, and the insidious type. Most cases (61%) show onset of eclampsia during the prenatal period. Treatment of eclampsia involves 1) control of convulsions (through an injection of magnesium sulphate or diazepam or the intravenous administration of phenytoin); 2) correction of hypoxia and acidosis; 3) a gradual lowering of blood pressure with hydralazine hydrochloride, nifedipine, atenolol, labetalol, oxprenolol, or metoprolol); and 4) steps to effect delivery. Diagnosis of HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) requires a complete blood count, blood film for platelet count and red blood cell fragmentation, and a coagulation screen for diagnosis of disseminated intravascular coagulation. Efforts to induce delivery in cases of prenatal eclampsia can take place 12-24 hours after convulsions have stopped. There is no reason to prolong pregnancy in the interests of the fetus, and in some cases Cesarean section may be required. Adequate prenatal care should allow the identification of almost every potential case of eclampsia and allow the prompt treatment of pre-eclampsia or termination of pregnancy when necessary. Medical staff must receive proper training to diagnose pre-eclampsia and treat the condition.
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PMID:Eclampsia. 765 39

A spontaneous retroperitoneal haematoma is an uncommon cause of haemorrhagic shock. We report a case of spontaneous rupture of a renal angiomyolipoma resulting in haemorrhagic shock in a 52-year-old woman. The renal tumor was recognized by sonography and diagnosed by CT-scan. Renal angiography was performed, but embolization was not successful. During the surgical procedure, nephrectomy was required because of persistent bleeding, related to disseminated intravascular coagulation. Outcome was uneventful. Diagnosis and treatment of renal angiomyolipoma are discussed. The Lenk's triad, consisting of acute lumbar pain, symptoms of internal bleeding and lumbar tumefaction, is the usual clinical picture of retroperitoneal haemorrhage. The kidney is the most frequent cause and renal angiomyolipoma is the most frequent benign tumor. Renal angiomyolipoma is either isolated or associated with tuberous sclerosis in up to 20 per cent of patients. Diagnosis is suggested by sonography and confirmed by CT-scan. Renal angiography, performed in haemodynamically stable patients, shows the origin of bleeding and allows embolization. Considering the frequent bilaterality of angiomyolipoma, surgery should be as conservative as possible in order to preserve renal function.
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PMID:[Spontaneous retroperitoneal hematoma: a rare cause of hemorrhagic shock]. 766 26

A 20 year-old female patient with Kasabach-Merrit syndrome, suffered from chronic consumption coagulopathy due to localized intravascular coagulation in the tumors. She had been diagnosed as Kasabach-Merrit syndrome immediately after birth and below knee amputation of her right lower leg was performed at the age of 2 years because of her giant hemangioma on the right foot and lower leg. After the operation, she had often complained of severe pain and enlargement of the residual tumors due to continuous thrombus formation within the tumors. She was admitted to the third Department of Tohoku University Hospital in order to initiate oral anticoagulant therapy with Warfarin at the age of 12 years. After the administration of 2.5 mg/day Warfarin, she has maintained good clinical condition until now, despite the occasional occurrence of coagulation abnormalities. We believe that the results of this case indicate the efficacy of oral anticoagulant therapy in the treatment of chronic consumption coagulopathies complicated with other diseases.
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PMID:[A case of Kasabach-Merrit syndrome complicated with DIC treated effectively by long term oral administration of warfarin]. 778 22

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

A few hours after a 15 km march a 19-year-old man developed a fever of 40 degrees C, accompanied by hemoptysis, tarry stools and pain in the thigh. On physical examination there was tenderness and swelling over the shoulders, upper arms and thighs as well as petechiae, bruises, hepatomegaly, pain on percussion over the kidney region and signs of hypovolaemia. There was leukocytosis (18,800/microliters) and increased creatinase activity (3900 U/l, rising to 66,300 U/l after 24 h). The platelet count fell from 147,000 to 11,000/microliters, the fibrinogen level to 0.25 milligrams. On the second day serum creatinine was 4.1 mg/dl, urine volume 50 ml/24 h, urinary myoglobin concentration 120,000 micrograms/l. The Quick value dropped to under 3%, while liver enzymes and bilirubin concentration rose. The rhabdomyolysis caused acute respiratory failure, despite symptomatic treatment of the acute renal failure and consumption coagulopathy, but after 8 weeks of intensive treatment the patient was discharged without symptoms. No cause other than the preceding physical exertion was found for the rhabdomyolysis. Muscle biopsy revealed unspecific changes 4 1/2 months after discharge.
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PMID:[Complications of an idiopathic rhabdomyolysis (Meyer-Betz syndrome) after physical exertion]. 786 81

60 patients with exacerbated gastric and duodenal ulcer were studied. Summary clinical effect was significantly better (by 12.34%, P < 0.05) in patients who were co-administered actovegin as compared to those who received conventional treatment (cholinolytics, antacids, reparative drugs and preparations of bismuth). The first group demonstrated more vigorous amelioration of pain, endoscopic involution and disappearance of disseminated intravascular coagulation signs as well as shorter hospital time.
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PMID:[The use of actovegin in peptic ulcer]. 808 61

We report on a female patient who attempted suicide by drinking 400 ml of 25% acetic acid. This amount is normally considered to be a lethal dose. Treatment was initiated about 2 hours after ingestion. Pain and shock were treated at first followed by the symptoms of haemolysis and renal failure. In severe corrosive injuries of the upper respiratory tract, intubation and ventilation are mandatory. After acid absorption, plasma separation is the quickest and most effective way of detoxication and removal of the products of haemolysis. In cases of severe haemolysis, exchange transfusion is necessary. In addition, careful management of the acid-base status is recommended. Disseminated intravascular coagulation or anaemia may develop. In this case, we used low dose heparin, erythrocyte transfusion and AT III substitution. In secondary renal failure, haemodialysis is recommended. When the acute intoxication has been treated, attention must be paid to fluid management and calorie intake. Care must be taken to exclude injury or stricture of the oesophagus or stomach. This case underlines the importance of immediate treatment of the haemolysis and detoxification with plasma separation with the immediate substitution of blood and clotting factors. In spite of an initial deterioration, the initiation of therapy led to a rapid improvement in circulation and renal function.
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PMID:[Acute oral acetic acid poisoning--case report]. 808 95

The Western diamondback rattlesnake, Crotalus atrox, is responsible for the majority of snakebites in Sonora, Mexico. We report 19 cases of children who were attacked by these snakes. Most of the rattlesnake attacks occurred in rural areas during the summer. The children's ages ranged from one to 15 years. The lower extremities, especially the legs, were most often bitten. The signs and symptoms presented by these patients included: pain, edema, limitation of motion, ecchymosis, bleeding and necrosis in the area of the bite, epistaxis, hematuria, and vomiting. Hospital treatment included: parenteral electrolyte solutions, antivenom serum, antibiotics, tetanus toxoid, blood transfusions, hydrocortisone, heparin, and peritoneal dialysis. In one case a fasciotomy was necessary. The observed complications on envenomations included: hemolysis, local necrosis, coagulation disorders, paresthesia, somnolence, and acute renal failure. One death occurred from disseminated intravascular coagulation.
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PMID:Rattlesnake bite complications in 19 children. 817 4

We report a 24-year-old man who presented unilateral multiple cranial nerve involvements followed by progressive paraplegia. The patient expired after developing DIC and pneumonia. Post-mortem examination revealed Ewing's sarcoma originated in the pubic bone with extensive metastases including the clivus which was responsible for his cranial nerve lesions. The patient was well until 24 years of age when he noted an onset of pain and a mass in the pubic region. The histology of the biopsy specimen of the tumor suggested Ewing's sarcoma. He was treated with chemotherapy and local radiation. A year after, he noted an onset of nuchal pain, difficulty in tongue movement, dysarthria, deafness in the left ear, and diplopia. On admission to our hospital in July 1990, neurological examination revealed an alert and intelligent Japanese male in no acute distress. The olfactory to the trigeminal nerves appeared intact. He showed complete abducens nerve palsy, facial weakness, mild deafness, and weakness of the soft palate, the sternocleidomastoid muscle and the tongue, all on the left side. The remainder of the neurological examination was unremarkable except for dysesthesia along the left C8 and Th1 dermatoms. Radiological examination revealed a 10 x 10 cm sclerotic mass in the public bone and a high signal mass lesion between the clivus and the pons in the T2-weighted MRI. His clinical course was complicated by acute paraplegia with anesthesia below the Th4 dermatom, DIC, and respiratory distress due to plural effusion. Post-mortem examination revealed a necrotic and hemorrhagic tumor in the pubic bone. The histology was consistent with Ewing's sarcoma.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A 24-year-old man presenting Garcin syndrome and paraplegia]. 847 71

A 50-year-old male was admitted to our hospital with severe malaise and lumbar pain. He suffered from diffuse bone metastasis of gastric cancer (mod. tub. adenocarcinoma) and DIC. In order to palliate his severe bone pain and bleeding tendency, FAM (5-fluorouracil 600 mg/body day 1, 7, 29, 36; doxorubicin 40 mg/body day 1, 29; and mitomycin C 12 mg/body day 1) combination chemotherapy was used. After administration of FAM therapy, bone pain and bleeding tendency due to DIC disappeared. For three months after initiation of chemotherapy, the patient's quality of life was maintained fairly well. Adverse reactions of FAM therapy were only appetite loss for several days. FAM therapy might be a useful regimen for palliation of bone pain and DIC due to diffuse bone metastasis of gastric cancer.
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PMID:[FAM as a palliative chemotherapy for gastric cancer with bone metastasis]. 854 59


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