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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 report concerns 20 patients with intrauterine fetal death. Blood samples for coagulation studies were obtained before, during and after delivery. No clinical defibrination or bleeding was noted. Coagulation defects were observed as follows: 2 biological defibrinations: The first case was a pregnancy of 32 wk with retention for more than 12 wk; hypofibrinogenemia was noted in all 6 samples, between 180 and 280 mg/100 ml. The second was a pregnancy of 32 wk with retention for more than 8 wk; fibrinogenemia was between 170 mg/100 ml and 140 mg/100 ml. 2 intravascular coagulations with normal fibrinogenemia, increase of fibrin degradation products and positive ethanol tests. 3 cases with slight coagulation defects that were difficult to explain. The coagulation defects appeared to be transient, and sometimes resolved themselves spontaneously. Induction of labour was made in 19 cases; quinine sulfate, used in 17 cases, was remarkably successful (1 intolerance, 1 failure). Study of the half-life of [125I]fibrinogen was made in 18 of the 20 cases. On average, it was reduced by half in comparison with the half-life of healthy men. The decrease was noted even in cases of fetal deaths without the coagulation defects detected by classical tests. The half-life of [125I]fibrinogen in 6 pregnant women before therapeutic abortion was also studied. The decrease of half-life was noted. Changes of metabolism of fibrinogen during pregnancy are discussed.
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PMID:Fetal death: coagulation defects and management. Report of 20 cases with study of the half-life of [125I]fibrinogen. 26 51

Liver changes and associated host responses were evaluated in four groups of male rats, weighing 300 +/- 20 gm., which received intravenous injection of 2.2 times 10(9) live Escherichia coli. This bolus was given either without additional treatment (group A) or prior to the following regimens: intramuscular injection of gentamicin sulfate, 5 mg. per kg. (group B); intravenous injection of methylprednisolone sodium succinate, 40 mg. per kg. (group C); and intramuscular injection of gentamicin immediately after methylprednisolone sodium succinate treatment (group D). Rats given injections of saline or methylprednisolone sodium succinate served as controls. Survival rates at 10 and 20 hours were 25 per cent and 4 per cent for group A; 44 per cent and 28 per cent for group B; 94 per cent and 70 per cent for group C; 98 per cent and 98 per cent for group D, respectively. In rats of groups A and B, killed at 1, 2, 4, and 6 hours, progressive liver changes included intravascular sequestration of rapidly degranulating leukocytes, fibrinous deposits, and platelet aggregates in sinusoids as well as in spaces of Disse adjacent to subendothelial collagen, and extensive Kupffer cell disruption in association with severe midzonal necrosis. These alterations were accompanied by progressive hypoglycemia and elevations of serum enzymes, glutamic pyruvic transaminase, lactate dehydrogenase, and glutamic oxaloacetic transaminase. Hematologic studies revealed that E. coli bacteremia results in rapid leukopenia and disseminated intravascular coagulation primarily due to activation of the intrinsic coagulation pathway. All above reactions were delayed and markedly reduced in rats treated with methylprednisolone sodium succinate. The results indicate that antibiotic treatment of lethal, Gram-negative bacteremia is effective only in conjunction with early steroid treatment. The protective effects of glucocorticoids on the liver microcirculation and polymorphonuclear leukocytes appear to play a basic role in preventing the early development of disseminated intravascular coagulation, hepatocellular necrosis, and associated major host responses, thereby attenuating lethality of gram-negative septic shock.
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PMID:Glucocorticoid and antibiotic effects on hepatic microcirculation and associated host responses in lethal gram-negative bacteremia. 36 36

One hundred and ninety-eight patients with congestive circulatory insufficiency were examined; 54 had stage IIA, 88 stage IIB, and 56 stage III of the disease. Blood viscosity, blood platelet and erythrocyte aggregation, fibrinogen disintegration products, and soluble fibrin were determined and the protamine sulfate test was performed. Statistically significant reduction of hematocrit, increase of erythrocyte aggregation, dysfunction of blood platelets, and increase in the content of products of fibrinogen and fibrin disintegration were revealed with progression of congestive circulatory insufficiency. These changes are evidence of disseminated intravascular coagulation in such patients and are important in prognostication.
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PMID:[State of hemostasis and blood rheology in congestive circulatory insufficiency]. 43 14

Decreased platelet count and platelet adhesiveness as well as increased values of the protamine sulfate test were found in 26 patients with septic abortion (9 of them anuric). Serum fibrinogen-fibrin related antigen (FR-antigen) values, detected in 13 patients (7 of them anuric) were greatly increased although euglobulin lysis time was rather prolonged (more than 400 min). Less increased FR-antigen values were noted in 15 cirrhotic patients with enhanced fibrinolytic activity in the circulating blood (euglobulin lysis time less than 120 min). These findings suggest that an important increase of FR-antigen in serum is likely to indicate a local fibrinolytic response to an initial coagulation event. Since platelet count and adhesiveness as well as FR-antigen and protamine sulfate test were similarly changed in patients with septic abortion who developed acute renal failure and in those who did not, it seems that the above mentioned parameters are not predictive for the evolution of thrombotic deposits and for possible renal complications following an episode of disseminated intravascular coagulation.
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PMID:Serum fibrinogen-fibrin related antigen and protamine sulfate test in patients with septic abortion and acute renal failure. 94 95

A study of coagulation disorders due to hepatitis A infection occurring during pregnancy was undertaken to determine if the unique coagulation status produced by pregnancy (elevated clotting factors and decreased fibrinolytic activity) was responsible for the increased severity of hepatitis A infections reported for pregnant women from various parts of the world. Of 49 patients studied, 12 (24%) developed hepatic failure and 9 (18%) died. A prolonged prothrombin time and low fibrinogen level were found to be as frequent as previously reported for nonpregnant patients with and without hepatic failure. Thrombocytopenia was less common and a long thrombin time was more common. Although intravascular coagulation was suggested by a lower mean fibrinogen level than expected in late pregnancy, mean platelet counts were similar to controls. The frequency of a positive protamine sulfate paracoagulation test for intravascular coagulation (DIC) was similar to that reported for uncomplicated pregnancy, and was of no prognostic value when performed on admission. We conclude that the severe clinical course of hepatitis during pregnancy in this epidemic was not attributable to a predisposition for DIC. However, once fulminant hepatitis occurred, DIC may have been a clinically significant factor.
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PMID:Coagulation studies of viral hepatitis occurring during pregnancy. 100 76

Soluble fibrin monomer complexes have been determined in approximately 500 obstetric patients by protamine sulfate precipitation, as a test for intravascular coagulation. The incidence of positive fibrin monomer was less than 1% in 139 samples drawn during normal pregnancy. In confirmed abruptio placentae, 84% of samples were positive, but other sources of antepartum bleeding were negative. Positive results were obtained in 24% of samples from patients between 3 and 48 hours after injection of hypertonic saline for second trimester abortion, 33% were positive by only 3% were positive after administration of prostaglandins. The test for intravascular coagulation is simple and rapidly carried out. The results correlated well with the clinical condition of patients with disseminated intravascular coagulation. However, the test is usually negative in patients with thromboembolic phenomena.
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PMID:Fibrin monomer as a test for intravascular coagulation. 111 81

Serial dilution protamine sulfate tests (SDPS) were performed in 191 women during labor. It was found that 27 per cent of women with uncomplicated pregnancies and 42 per cent with complicated pregnancies had positive SDPS tests, the highest incidence being between three and six hours of labor. These findings support the previous report of a physiologic disseminated intravascular coagulation in pregnancy but make the SDPS test of little value in obstetric cases.
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PMID:Intravascular coagulation in obstetrics: Serial dilution protamine sulfate test throughout labor. 124 42

We previously studied fibrinolysis and fibrinogenolysis by analyzing fragments of fibrin/fibrinogen degradation products (FDP) employing sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting. In this report, we characterized the fragments of FDP in four patients with disseminated intravascular coagulation (DIC), that were caused by various diseases. In the patients suffering from acute lymphoblastic leukemia (case 1) and acute suppurative cholangitis (case 3), DD and DY/X fragments resulting from fibrinolysis accounted for the most part of the FDP fragments. In case 3, D fragments resulting from fibrinogenolysis were also observed to much less extent. In a DIC associated with acute myeloblastic leukemia (case 2), both fibrinolysis and fibrinogenolysis were increased and resulted in high levels of D, Y and DY/X fragments, concomitant with moderate levels of DD and high molecular weight (HMW) fragments in the patient's sera. The increased fibrinogenolysis in this case was attributed to accelerated activation of plasmin. In a DIC patient of case 4, who underwent an operation due to hepatocellular carcinoma, marked increase in DY/X and HMW fragments and slight increase in DD fragment were observed on the day of operation. Hyperfibrinolysis documented in case 4 was explained by both increased production of thrombin and moderately accelerated activation of plasmin. Both qualitative and quantitative changes in the fragments of FDP during the courses of treatment in two cases of DIC were also noted. In summary, each underlying disease expresses characteristic pattern of FDP fragments in DIC.
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PMID:[Studies on the fragments of FDP in 4 patients with DIC]. 130 14

Previous studies on recombinant human soluble thrombomodulin (rsTM) from Chinese hamster ovary cells revealed that rsTM was expressed as two proteins that differed functionally in vitro due to the presence (rsTM beta) or absence (rsTM alpha) of chondroitin-4-sulfate. The current study evaluates the in vivo behavior of rsTM in rats and in a rat model of tissue factor-induced disseminated intravascular coagulation (DIC). rsTM beta was more potent than rsTM alpha for prolongation of the activated partial thromboplastin time (APTT) and their in vivo half-lives determined by ELISA were 20 min for rsTM beta and 5.0 h for rsTM alpha. Injection of a tissue factor suspension (5 mg/kg) resulted in DIC as judged by decreased platelet counts and fibrinogen concentrations, prolonged APTT, and increased fibrin and fibrinogen degradation products (FDP) levels. A bolus injection of either rsTM (0.2 mg/kg) 1 min before induction of DIC essentially neutralized effects on platelets, fibrinogen, and FDP levels, and had only a moderate effect on APTT prolongation. The dose of anticoagulant to inhibit the drop in platelet counts by 50% (ED50) was 0.2 mg/kg rsTM alpha, 0.07 mg/kg rsTM beta, and 7 U/kg heparin. The effect of increasing concentrations of rsTM and heparin on bleeding times were compared in experiments involving incision of the rat tail. Doubling of the bleeding times occurred at 5 mg/kg rsTM alpha, 3 mg/kg rsTM beta or 90 U/kg heparin. These values represent a 25-fold increase over the ED50 for rsTM alpha, 43-fold for rsTM beta and 13-fold for heparin.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The glycosaminoglycan of recombinant human soluble thrombomodulin affects antithrombotic activity in a rat model of tissue factor-induced disseminated intravascular coagulation. 132 70

Patients with liver disease have a variety of coagulation abnormalities. These derangements are of uncertain origin and do not always correlate with disease severity or activity. We have measured the levels and proportions of the total fibrin-related and fibrinogen-related antigens, the principal fibrin (D-dimer) and fibrinogen (D-monomer) degradation fragments and intermediates of fibrin formation (fibrin monomers) in patients with a variety of acute and chronic liver diseases in whom all known other precipitating causes of disseminated intravascular coagulation had been excluded. Fibrin-related and fibrinogen-related antigens were extracted from serum using antihuman fibrinogen-IgG covalently bound to activated amino-phenylthioether paper disks and were subjected to 4% to 11% sodium dodecyl sulfate-polyacrylamide gel electrophoresis under nonreducing conditions. Fibrin-related and fibrinogen-related antigen proportions were determined by densitometry, and their levels were measured by radioimmunoassay. Levels of total fibrin-related and fibrinogen-related antigens (and D-dimer) were significantly elevated (p less than 0.01) in patients with cirrhosis (121 to 641 ng/ml) and hepatocellular carcinoma (416 to 8,786 ng/ml) when compared with patients with acute viral hepatitis (84 to 322 ng/ml) and control subjects (38 to 186 ng/ml). In addition, D-monomer levels were elevated. These findings strongly suggest that disseminated intravascular coagulation is a component of the coagulopathy of certain liver diseases. Because fibrin-related and fibrinogen-related antigens have anticoagulant, vasoactive and immunosuppressive properties, their elevated presence may be biologically significant in these patients.
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PMID:Elevated fibrin-related and fibrinogen-related antigens in patients with liver disease. 132 11


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