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Query: UMLS:C0012739 (
disseminated intravascular coagulation
)
8,673
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Glomeruli possess a complex hemostasis system with prothrombotic (procoagulant, antifibrinolytic) and antithrombotic (anticoagulant, fibrinolytic) properties that can act locally on platelet adhesion or aggregation, on plasmatic coagulation pathways, and on fibrinolysis. In vitro, inflammatory mediators, such as TNF, favor glomerular thrombogenic properties through enhancement of thromboplastin synthesis and of plasminogen activator inhibitor PAI-1, and through decrease in thrombomodulin activity. In some diseases, intraglomerular fibrin formation appears to be favored by increased glomerular prothrombotic properties, for example: augmented thromboplastin activity in immune glomerulonephritides and in Shwartzman phenomenon, excessive thromboxane A2 synthesis, and decreased fibrinolytic activity in severe renal allograft rejection. In other diseases glomerular hemostasis appears to function homeostatically, for example, in
thrombin
-induced
disseminated intravascular coagulation
with enhancement of fibrinolytic activity favoring fibrin dissolution. Novel methods allowing the study of glomerular hemostatic activities in renal biopsy fragments should help to understand the mechanisms of fibrin deposition in human diseases and to treat it on a logical basis.
...
PMID:Glomerular coagulation system in renal diseases. 150 74
The purpose of the study was to explore hemostasis in children suffering from hemorrhagic vasculitis (HV) by means of the new amidolytic methods using chromogenic substrates. The patient's plasma was studied for the content of
thrombin
, trypsin, factor Xa, AT-III, kallikrein, plasmin, free heparin, urokinase, factor 3 of platelets, prothrombin and Willebrand's factor. 69 children with HV were entered into the study. All of them were examined during crises. In cutaneous HV, the content of trypsin decreased 3-fold, the content of factor Xa increased 5-fold; there was a negligible increase in the plasmin and AT-III levels; the content of kallikrein rose 2-fold, that of urokinase 60-fold; the release of platelet factor 3 was intensified 1.5-fold, the activity of prothrombin 3-fold. These data indicate that in cutaneous HV, blood coagulation increased. However, the signs of
disseminated intravascular coagulation
were lacking because of the high blood anticoagulant activity. In mixed HV, the phase of hypercoagulation was not made for by the blood anticoagulant activity, since the latter one was depleted. The capillary toxic nephritis may give rise to
disseminated intravascular coagulation
associated with the depletion of the anticoagulant component. The gravity of HV and its complications can be predicted according to the characteristics of the anticoagulant component of hemostasis, especially according to the levels of urokinase and AT-III.
...
PMID:[State of hemostasis in hemorrhagic vasculitis in children]. 151 26
Although the possible occurrence of systemic fibrinogenolysis has been suggested in patients with metastasising prostatic cancer (MPC), direct evidence is lacking. We report on a patient with MPC whose laboratory data were consistent with hyperfibrinolysis: marked decrease of alpha 2-antiplasmin (AP) level (less than 50% of normal), increase of plasmin-alpha 2-antiplasmin complex, D-fragment of fibrin and fibrinogen degradation products [FDP(D)] and cross-linked fibrin degradation products (XDP). The patient neither showed laboratory nor clinical evidence for
consumption coagulopathy
except for a slight increase in
thrombin
-antithrombin III complex level. Immunoblotting of the patient's serum using an anti-fibrinogen antibody revealed the presence of a 250 kDa protein in addition to DD fragments. Following reduction of this protein by 2-mercaptoethanol after extraction from SDS-PAGE gel, gamma-chain of fibrinogen (47 kDa) was found by immunoblotting using a monoclonal antibody recognising a 86-302 residue of the gamma-remnant of fibrinogen. Moreover, the 250 kDa protein did not bind to Sepharose 4B to which a monoclonal antibody recognising the N-terminus of fragment D was conjugated. These findings indicated that this protein was not fragment DY, but rather fibrinogen fragment X. With the retraction of the prostatic tumour by an effective therapy, the patient's AP level increased gradually. When the plasma AP level rose to 60% of normal, the fragment X was no longer detectable. These findings suggested that systemic fibrinogenolysis occurred in the patient with MPC only when AP levels were markedly decreased.
...
PMID:Direct evidence for systemic fibrinogenolysis in a patient with metastatic prostatic cancer. 151 30
An ELISA assay for quantitation of the
thrombin
-heparin cofactor II complex (T-HC II) in plasma was developed. Plasma was incubated with immobilized, specific antibodies to human
thrombin
. The second, biotinylated antibody was directed against human HC II. The assay was insensitive to
thrombin
-antithrombin complex (TAT) and to uncomplexed HC II. In plasma samples from 31 normal individuals (aged 21-68, mean 43.3 years), the T-HC II ranged 0.3-6.1 ng/ml; median 1.5, mean 2.0, and SD 1.6 ng/ml. In plasma samples from 13 patients with
disseminated intravascular coagulation
(
DIC
), T-HC II ranged 0.4-30.0 (median 13.5) ng/ml. In plasma samples from 6 patients in which the clinical suspicion of
DIC
was not verified, T-HC II complex ranged 1.4-14.3 (median 3.6) ng/ml. In plasma samples with elevated T-HC II levels, TAT was usually elevated, and on the average more than was T-HC II. These results indicate that HC II contributes significantly to the inactivation of in vivo generated
thrombin
.
...
PMID:Elevated levels of thrombin-heparin cofactor II complex in plasma from patients with disseminated intravascular coagulation. 152 13
We report the case of a patient with recurrent hemorrhagic choroidal detachments after combined cataract and filtering surgery associated with exacerbation of chronic
disseminated intravascular coagulation
(
DIC
). It was postulated that the formation and drainage of the hemorrhagic choroidal detachments induced
thrombin
generation and consequently coagulation factor and platelet consumption. Fibrinolysis resulted in the release of fibrin-degradation products (FDP). Consumption of clotting factors and platelets combined with FDP release may result in decompensation of a chronic
DIC
state and cause a bleeding diathesis. This case shows the need for complete hematologic evaluation of patients with hemostatic abnormalities.
...
PMID:Recurrent hemorrhagic choroidal detachment associated with disseminated intravascular coagulation. 156 29
Recent progress in elucidating the complex and heterogeneous interactions between malignancy and coagulation or fibrinolysis reactions in humans has clarified the pathogenesis of
disseminated intravascular coagulation
that occurs with malignancy and has revealed evidence for two distinct pathways of growth regulation based on production by tumor cells of initiators of
thrombin
formation versus plasminogen activators. We have proposed a preliminary classification of tumors (see Table 2) based on these interactions. Type I tumors are those in which the tumor cells are associated with an intact coagulation pathway that leads to
thrombin
formation at the tumor periphery but in which the tumor cells lack u-PA. Examples of tumors in this category include SCCL, malignant melanoma, and renal cell carcinoma. Type II tumors are those in which the tumor cells express u-PA but lack an associated coagulation pathway leading to
thrombin
formation. Examples of type II tumors include prostate cancer, colon cancer, breast cancer, and N-SCLC. Type III tumors are those that express neither of these pathways, or exhibit some other pattern of interaction. Obviously, this formulation must be regarded as hypothetical. However, this concept fits with the limited data available to date from clinical trials. More importantly, this hypothesis can be tested further by means of intervention aimed at interrupting pathways relevant to specific tumor types. Characterization of additional tumor types by the methods described should permit amplification of this classification of tumors and other patterns of interaction may be defined. Exploration of the coagulation-cancer interaction holds considerable promise for gaining new understanding of both the coagulation mechanism and tumor biology. Most intriguing is the prospect that imaginative approaches to cancer treatment may be devised that are not only relatively nontoxic and low cost, but also effective.
...
PMID:Pathways of coagulation/fibrinolysis activation in malignancy. 157 11
Disseminated intravascular coagulation (DIC)
can be defined as evidence of activation of the coagulation mechanism resulting in proteolysis of fibrinogen by
thrombin
and plasmin and an acute thrombocytopenia. The association of pulmonary embolism (PE) with
DIC
has recently been reported but in reviewing recent textbooks of hematology, there is no mention of PE as a cause of
DIC
. Clinicians need to be made aware of this association since it affects the patient who is thought to be autoanticoagulated as well as the patient who has
DIC
of unknown cause. PE needs to be included in the differential diagnosis of an autoanticoagulated state and in
DIC
of unknown etiology. In both instances the recommended treatment is full-dose intravenous heparin therapy.
...
PMID:Massive pulmonary embolism presenting as disseminated intravascular coagulation. 160 44
Antithrombotic effect of recombinant human thrombomodulin (TM) on experimentally induced thrombosis in mice was studied. The soluble recombinant human TM (TMD 123), which was expressed in Chinese hamster ovary cells and purified from the conditioned medium, prolonged
thrombin
clotting time for mouse plasma in a dose-dependent fashion. Thrombosis was induced by the injection of lipopolysaccharide (LPS) from E. coli into a lateral tail vein of mice and was identified as
disseminated intravascular coagulation
(
DIC
) syndrome by hematological and histological examinations. Simultaneous injection of TMD 123 with LPS into another lateral tail vein of mice significantly corrected the hematological abnormalities compatible with
DIC
, and also corrected the histological abnormalities i. e. fibrin deposition and decrease of cellular TM in the target organs including kidney, liver and lung. These results indicate that recombinant human TM is a potent antithrombotic agent and that this would be an expectative anticoagulant for
DIC
or thrombosis in man.
...
PMID:[Antithrombotic effect of recombinant human thrombomodulin on experimentally induced thrombosis in rats]. 165 29
Thrombomodulin (TM) is an endothelial cell membrane glycoprotein which neutralizes
thrombin
clotting activity and accelerates
thrombin
-catalyzed activation of plasma protein C. Its role is considered to be very important to prevent thrombosis. Recently, TM has been found in circulating blood and the roles and the functions have been investigated. In this study, we evaluated the reliance and the clinical usefulness of a TM-measuring-kit by enzyme immunoassay (MGC-01-001: Mitsubishi Gas chemical company). Intraassay reproducibility test, dilution linearity test and in vitro recovery test was obtained satisfactory results. A correlation between plasma and serum on TM levels of healthy individuals was very good and the difference between them was not significant. Normal value of plasma TM levels was instituted 15.73 +/- 6.98 ng/ml by measuring 52 healthy adults. The difference between male and female was not significant. Plasma TM levels did not change significantly after venous occlusion test and on circadian fluctuation. Plasma TM levels in patients with occlusion test and on circadian fluctuation. Plasma TM levels in patients with
disseminated intravascular coagulation
(
DIC
) was 40.15 +/- 22.68 ng/ml (mean +/- SD, n = 14). It is significantly higher than the levels in healthy adults. However, the levels in patients with angina pectoris, acute myocardial infarction and aortic aneurysm were not significantly different from those of healthy adults. These findings suggest that the precision of this TM-measuring-kit is satisfactory and the measurement of plasma TM can be useful to diagnose of
DIC
.
...
PMID:[Evaluation of an enzyme immunoassay for plasma thrombomodulin]. 165 17
Changes in
thrombin
-antithrombin III complex (TAT) over a one week period studied in 42 cases of
disseminated intravascular coagulation
(
DIC
); 19 treated with standard (or unfractionated) heparin (UFH) and 23 treated with low-molecular-weight heparin (LMWH). Closer examination of short term changes in TAT (determined 2, 6, 12, 24, 48, and 72 h after starting anticoagulant therapy) was performed in ten cases of
DIC
; six treated with UFH and four treated with LMWH. In twelve of the 19 cases of
DIC
treated with UFH and 19 of the 23 cases treated with LMWH, plasma levels of TAT decreased one day after starting anticoagulant therapy, and no exacerbation of
DIC
was observed for the following week. In the other cases, these levels further increased and most patients had persistently high levels of TAT for the next week. Plasma levels of TAT were significantly lower in patients treated with LMWH than in those treated with UFH, which may suggest that LMWH is more beneficial in
DIC
. A transient increase in plasma levels of TAT was observed 6 h after the start of anticoagulant therapy in two of the six cases treated with UFH and one of the four cases treated with LMWH. From these results we conclude that fluctuation of TAT was not influenced by the type of heparin (UFH or LMWH), and that the course of
DIC
for the following week can be predicted by the changes in plasma TAT levels one day after starting anticoagulant therapy.
...
PMID:The course of disseminated intravascular coagulation is predicted by changes in thrombin-antithrombin III complex levels--is there any difference between treatment with standard heparin or low-molecular-weight heparin? 166 51
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