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)

Intrauterine growth retardation and neonatal transient mucocutaneous lesions ("transient Behcet syndrome") have been reported in pregnancies complicated by Behcets disease (BD). Neonatal neurological manifestations have not been reported in such pregnancies. Vascular and neurological involvement is known to worsen the prognosis in adults with BD. The clinical course and outcome of a 34-weeks' gestation neonate born to a mother with BD is reported. Progressive recovery from minimal respiratory distress syndrome was followed by catastrophic presentation on 6th day of life with generalized seizures. Cranial ultrasound revealed multiple hyperechoic lesions in the frontal, parietal, and periventricular regions with a few surrounded by a ring of reduced echogenicity suggesting haemorrhage into ischemic areas. Death occurred after withdrawal of life support on Day 9, after extensive discussions with parents in view of the progressive deterioration in the neonates' general condition and the cranial ultrasound findings. Strong family history of BD, clinical course, and laboratory results (no evidence of disseminated intravascular coagulation, normal levels of protein C and S, absence of factor V Leiden and anticardiolipin antibodies) suggested neurological manifestations of BD as the most probable diagnosis.
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PMID:Unusual presentation of neonatal Behcets disease. 1155 81

Heat stroke occurs in the desert area of Saudi Arabia quite frequently and manifest in different patterns including coagulopathy. Frequently encountered complications include renal or hepatic failure, rhabdomyolysis, acute respiratory distress syndrome (ARDS), disseminated intravascular coagulation (DIC), and seizure. Not all of these complications usually occur in the same patient, in case it occurs the mortality reported is significantly high. We describe a case of heat stroke that had nearly all the known complications of heat stroke but recovered from all, except minor neurological deficit in the form of dysarthria and exaggerated deep reflexes.
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PMID:Classic heat stroke in a case of simple hypohydrosis with "bad prognostic indicators" but a remarkable recovery. 1172 20

A ten-case report of Streptococcus suis infection was reported in Lamphun, northern Thailand from 1999 to 2000. Ten patients were admitted to Lampoon Provincial Hospital with a history of high fever, watery diarrhea, severe myalgia and ecchymosis rashes. The disease progressed rapidly and all patients died within 24-48 hours after admission from complications such as disseminated intravascular coagulation (DIC), acute renal failure (ARF) or acute respiratory distress syndrome (ARDS). Epidemiological data revealed that all cases were healthy men aged between 40-49, residing in the same geographical area and had a history of raw pork or uncooked pig's blood consumption prior to their illnesses. Blood culture and genetic investigation (16 s rRNA polymerase chain reaction with restriction enzyme PstII) confirmed diagnoses of the same species of Streptococcus suis infections.
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PMID:Streptococcus suis infection in northern Thailand. 1180 63

Adult onset Still's disease (AOSD), the adult variant of the systemic form of the juvenile rheumatoid arthritis, is an uncommon disorder of unknown origin. Although the pathogenesis has not yet been clarified, an immunologically mediated inflammation occurs in active AOSD. High spiking fever, evanescent maculo-papular skin rash, arthralgias/arthritis, neutrophilic leukocytosis, negative rheumatoid factor and antinuclear antibodies, as well as a marked hyperferritinemia are the major features of AOSD. Sore throat, lymphadenopathies, hepato-splenomegaly, abdominal pain, polyserositis, respiratory distress syndrome, multiple organ dysfunction and disseminated intravascular coagulation may also occur. The clinical course of AOSD is extremely variable and unpredictable and can be divided into three main patterns: a self-limited or monocyclic pattern, a polycyclic or intermittent course, with one or more flares of the disease and complete remission among the episodes, and a chronic course, characterized by persistently active disease, usually due to a chronic, destructive arthritis. Since there are not pathognomonic laboratory parameters or histological findings, the diagnosis of AOSD requires the exclusion of infectious, malignant and autoimmune disorders. Some sets of criteria for classification have been proposed, but so far not validated. The prognosis of AOSD is usually considered relatively benign, although a destructive arthritis may cause severe disability and the multisystemic life-threatening complications of the disease may determine a fatal outcome. Treatment usually consists in nonsteroidal anti-inflammatory drugs and corticosteroids, but a more aggressive approach with disease modifying antirheumatic or immunosuppressive drugs may be required.
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PMID:[Adult onset Still's disease]. 1185 Jun 12

This clinical-pathological conference took place at the Sourasky Medical Center, Tel Aviv, on February 21, 2001. We present the case of a young and previously healthy soldier who developed multi-organ failure with predominant liver dysfunction following exertional heatstroke. The patient's clinical course consisted of an early phase of transient encephalopathy, associated with hyperthermia, hypophosphatemia, mild laboratory indications of renal failure, rhabdomyolysis and consumption coagulopathy. Following an intermediate convalescing phase that lasted a single day the patient deteriorated into a catastrophic course with hemodynamic instability, fulminant hepatic failure, respiratory distress, kidney failure, rhabdomyolysis, coagulopathy and coma. He died 4 days later. In this article we elaborate on the association of heatstroke with multiple organ dysfunction syndrome in general, and fulminant liver failure in particular. The nature of hypophosphatemia and the possible role of additional injury from acetaminophen are discussed.
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PMID:[Multi-organ failure in a young soldier: a clinical-pathological meeting]. 1190 96

Fibrin deposits found in the pulmonary microcirculation and in the small airways of preterm infants with severe respiratory distress syndrome (RDS) has been explained by the activation of the coagulation system and/or insufficient fibrinolysis. Previous studies suggest that disseminated intravascular coagulation is not prominent in the early stages of RDS, and there is a reduced fibrinolytic activity in these patients. The in vitro evaluation of body's fibrinolytic potential is difficult in contrast to blood clotting because fibrinolysis is only activated after coagulation. To solve this problem a standardized assay was developed to measure the global fibrinolytic capacity (GFC) in plasma. This assay allows us a sensitive and reliable parameter to evaluate the fibrinolytic potency of plasma in vitro. We therefore studied GFC in the first 6 hr after birth in preterm infants who later developed RDS. Global fibrinolytic capacity which is expressed as generated D-dimer concentrations was significantly lower in preterm infants who later developed RDS compared to the control group in this study. These findings support our previous hypothesis of "reduced fibrinolytic state in early RDS".
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PMID:Global fibrinolytic capacity in early respiratory distress syndrome: a pilot study. 1192 Oct 19

We report a case of multiple organ dysfunction following epididymitis. A 53-year-old male patient was admitted to our emergency room with bilateral clavicular fractures, multiple costal fractures and left hemopneumothorax due to a traffic accident. Open reduction of the right clavicular fracture was performed under general anesthesia on the sixth hospital day. A bladder balloon catheter was inserted after induction of anesthesia. The clinical course in the perioperative period was satisfactory and the bladder balloon catheter was removed on the seventh hospital day. However, spontaneous left scrotal pain with tenderness, intense heat with swelling developing on the tenth hospital day, and hypotension, dyspnea and oliguria were noted on the eleventh hospital day. Blood chemistry data showed severe inflammatory findings. Chest X-ray showed acute respiratory distress syndrome. Blood coagulation data showed pre-disseminated intravascular coagulation. The patient's condition continued to deteriorate and we suspected septic shock due to left epididymitis. Emergent left orchiectomy was performed under local anesthesia on the twelfth hospital day. Postoperatively he recovered rapidly. We consider that multiple organ dysfunction following postoperative epididymitis was caused by cytokines released due to systemic inflammatory response syndrome (SIRS) after the trauma, operation, and placement of the bladder catheter. In conclusion, it is important to note that patients with SIRS should undergo further examinations of septic shock immediately and resection of the causative tissue should be performed as soon as possible.
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PMID:[A case of multiple organ dysfunction following postoperative epididymitis]. 1205 38

Reports about anaphylactic and anaphylactoid reactions to rocuronium have increased recently. We report two new cases of documented grade III anaphylaxis, leading to death in one patient. The first case occurred in an 81-year-old ASA II woman scheduled for emergency abdominal surgery. Severe hypotension and tachycardia were observed after rocuronium, without bronchospasm. Neosynephrine allowed rapid resuscitation, and the patient recovered fully. The second patient was a 64-year-old ASA II man scheduled for abdominal surgery. Severe haemodynamic instability and bronchospasm occurred after rocuronium. Despite immediate life support, the postoperative period was complicated by persistent low systolic pressure, acute respiratory distress syndrome, acute renal failure, disseminated intravascular coagulation and pancreatitis, leading to the death of the patient.
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PMID:Anaphylaxis to rocuronium. 1256 31

Two patients presented to the Emergency Department (ED) with features of toxic shock syndrome, including hypotension, acute respiratory distress syndrome (ARDS), renal and hepatic insufficiency and disseminated intravascular coagulation (DIC). Computed tomography (CT) scan identified the source of infection in one patient. At laparotomy, pelvic peritonitis and massive edema of the pelvic retroperitoneal tissue was found. The other patient had myonecrosis of the forearm necessitating amputation. Intra-operative cultures of tissue in each case yielded Streptococcus pyogenes, Group A. These patients were treated early with clindamycin and intensive supportive care as well as surgery, and both made a full recovery. Because of the necessity of early recognition of the varied presentation of these infections, the clinical features as well as essential interventions are emphasized. We review the pathophysiology of invasive Group A streptococcal infection to increase awareness of these uncommon but fulminant and often lethal infections.
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PMID:Fulminant infection and toxic shock syndrome caused by Streptococcus pyogenes. 1274 58

Heat waves result in excess deaths, excess emergency department visits, and intensive care unit admissions for heat stroke. We describe the clinical features and 3-month outcome of a patient with near-fatal heat stroke, admitted to our intensive care unit in July, 2001. After heavily working for hours at a construction site during a heat wave, the 28-year-old male presented with 41.4 degrees C body temperature and multiorgan failure, consisting of neurological impairment, rhabdomyolysis, acute renal failure, disseminated intravascular coagulation, and acute respiratory distress syndrome (ARDS). In the first week there was no evidence of infection. Treatment included cooling, aggressive volume resuscitation, administration of antithrombin-III concentrates and steroids. The patient survived and recovered normal neurological, renal, respiratory and haematological function, and no disability persisted. This case illustrates survival and complete recovery after multiorgan failure in heat stroke with vigorous intensive care. Treatment with antithrombin and steroids and may well have contributed to the favourable outcome. Correction of reduced antithrombin III levels to supranormal by therapeutic administration of antithrombin III concentrate in disseminated intravascular coagulation of heat stroke was not associated with any bleeding complications.
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PMID:Antithrombin and near-fatal exertional heat stroke. 1216 65


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