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Query: UMLS:C0012739 (
disseminated intravascular coagulation
)
8,673
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Hemorrhagic fever with renal syndrome in Korea (Korean hemorrhagic fever) is an acute viral disease characterized by fever, hemorrhage and renal failure. In Korean patients, the disease manifests more distinctive bleeding tendencies than those of hemorrhagic fever with renal syndrome found in western countries. To investigate the nature and role of the coagulation, fibrinolysis, kinin and immune system in the pathogenesis of such a hemorrhagic manifestation, alterations of these systems were assessed from the early phase of the disease. Decreased platelet count and shortened platelet survival were observed with giant platelets in the peripheral blood. The marked prolongations of bleeding time, prothrombin time and partial thromboplastin time were noticed with the decreased plasma activities of coagulation factors II, V, VIII, IX and X. Shortened half life of fibrinogen, increased fibrinogen-fibrin degradation product, with decreased plasma levels and activities of plasminogen,
alpha 2-plasmin inhibitor
and antithrombin III were found. On thrombelastogram, the existence of procoagulant activity was confirmed, and prolonged reaction time and clot formation time with decreased maximum amplitude were observed. The appearance of circulating immune complexes was found along with decreased C3 and normal C4 in the serum. Significant decrease of serum C3 was evident in the patients with
disseminated intravascular coagulation
. These findings of coagulopathy were normalized within ten days of the illness in most cases. Therefore, it can be concluded that
disseminated intravascular coagulation
and thrombocytopenia in the early phase, and azotemia developing later might play an important role in the pathogenesis of bleeding tendency in Korean hemorrhagic fever.
...
PMID:Coagulopathy in patients with hemorrhagic fever with renal syndrome. 315 65
Six coagulation proteins were measured in 79 consecutive patients referred to the coagulation service for suspected
disseminated intravascular coagulation
. Antithrombin III, plasminogen, and
alpha 2-plasmin inhibitor
were measured with fluorescent substrate assays. Fibronectin, prothrombin, and protein C were measured with electroimmunoassays. Using history and physical findings and the results of a coagulation screen (prothrombin time, partial thromboplastin time, fibrinogen, fibrin[ogen] degradation products, platelet count, and peripheral smear), the 79 patients were classified into five categories: no
disseminated intravascular coagulation
(n = 21), elevated fibrin(ogen) degradation products without other evidence of coagulopathy (n = 44),
defibrination
syndrome (n = 9), microangiopathic thrombocytopenic purpura (n = 4), and primary fibrinolysis (n = 1). Because the sensitivity and specificity of each of the proteins could not easily be compared, receiver operating characteristic (ROC) curves and areas under the ROC curves were calculated for each of the six proteins as well as for the tests of the coagulation screen. The ROC curves indicated that, apart from plasminogen, the other coagulation proteins provided little additional information about the classification of the coagulopathy.
...
PMID:Diagnostic efficacy of six plasma proteins in evaluating consumptive coagulopathies. Use of receiver operating characteristic curves to compare antithrombin III, plasminogen, alpha 2-plasmin inhibitor, fibronectin, prothrombin, and protein C. 376 44
To clarify the hemocoagulative and fibrinolytic dynamics of the perinatal period and also to seek the cause of SGA (small for gestational age) baby birth, the coagulation and fibrinolysis of the cord blood were examined, and moreover a comparison with the maternal blood, discussion on the difference in birth weight, and an examination of the difference due to the sex of babies were made in 68 cases with full-term, vaginal, spontaneous delivery, and the following conclusions were reached. In comparison with maternal blood, cord blood significantly showed any of the following: Prolongations of the prothrombin time, and the activated partial thromboplastin time, a decrease in fibrinogen, and a decrease in the platelet aggregation, antithrombin III, and plasminogen. In addition, high values for thromboxane B2 and 6-ketoprostaglandin F1 alpha were observed. In the SGA group, significant decreases were observed in the platelet count, antithrombin III, plasminogen, and
alpha 2-plasmin inhibitor
as compared with the AGA (appropriate for gestational age) and LGA (large for gestational age) baby groups. No sex difference was observed in the hemocoagulative and fibrinolytic capacities of the cord blood. These hemocoagulative and fibrinolytic capacities, particularly changes in the fibrinolytic system observed in the SGA group, seem to be attributable to chronic
DIC (disseminated intravascular coagulation)
and mild acidosis due to various stresses during pregnancy and at parturition, in turn due to immaturity of the liver in babies.
...
PMID:[Blood coagulation and fibrinolysis in cord blood with reference to birth weight]. 405 31
In determination of antiplasmin activity of
alpha 2-plasmin inhibitor
(alpha 2 PI) using an amidolytic method, alpha 2-macroglobulin (alpha 2 M) in concentrations present in normal plasma inhibits the cleavage of chromogenic substrates by plasmin even if the reaction time between alpha 2M and plasmin is shortened as much as possible. The purpose of this study was to develop a new method to assay alpha 2 PI selectively with the chromogenic substrate S-2251 using an end-point method. The antiplasmin activity of alpha 2 M was destroyed by the addition of methylamine hydrochloride. In a case of congenital alpha 2 PI deficiency, antiplasmin activity determined with the previous method without the addition of methylamine was 20% of normal plasma, whereas the results obtained using this newly developed method was 5%. A statistically significant correlation between alpha 2 PI levels determined with this method and with a single radial immunodiffusion method was observed in plasma samples collected from 40 healthy subjects and 11 patients with
disseminated intravascular coagulation
(
DIC
). In two cases of
DIC
, in which markedly depleted levels of alpha 2 PI and normal concentrations of alpha 2 M were observed, antiplasmin activities measured without the addition of methylamine were higher than the ones measured immunologically, whereas the results obtained with the method described here were in accordance with the antigenicities of alpha 2 PI.
...
PMID:Selective determination of alpha 2-plasmin inhibitor activity in plasma using chromogenic substrate. 620 Sep 49
An enzyme-linked immunosorbent assay (ELISA) has been developed for the quantification of alpha 1-antitrypsin-human leukocyte elastase (alpha 1AT-E) complexes. In the ELISA, the alpha 1AT-E complex is bound to a surface by rabbit antileukocyte elastase antibody, and the inhibitor-proteinase complex is quantified by a second antibody, rabbit anti-alpha 1-antitrypsin F(ab')2, labeled with alkaline phosphatase. alpha 1AT-E complexes were detected when a final concentration of 2.2 nmol/liter of leukocyte elastase was added to plasma. The concentration of these complexes increased with additional elastase. In clotting blood, alpha 1AT-E complexes were generated in parallel with the conversion of 125I-fibrinogen to fibrin, whereas
alpha 2-plasmin inhibitor
-plasmin (alpha 2PI-P) complexes were not formed. The concentration of alpha 1AT-E complexes in 19 of 21 controls was less than 2.2 nmol/liter. Patients with laboratory evidence for
disseminated intravascular coagulation
(
DIC
) demonstrated elevated alpha 2PI-P complexes with either increased or normal concentrations of alpha 1AT-E complexes. Patients without evidence for
DIC
, but who demonstrated prolonged reptilase clotting times, were studied. This group had increased alpha 1AT-E but normal alpha 2PI-P complex levels, raising the possibility that elastase release in vivo may be accompanied by limited degradation of fibrinogen. These assays thus serve as useful probes for the study of leukocyte activation and of the interactions between cellular and plasma proteolytic enzyme systems.
...
PMID:Alpha-1-antitrypsin-human leukocyte elastase complexes in blood: quantification by an enzyme-linked differential antibody immunosorbent assay and comparison with alpha-2-plasmin inhibitor-plasmin complexes. 621 25
Ninety five patients with cerebrovascular accidents were studied on their coagulation and fibrinolysis at acute stage of their onset. From the data collected in the present study, following findings were obtained; 1) Hypercoagulable state, which are responsible for the decreased antithrombin III levels, was observed at acute stage of cerebral infarction. 2) Findings from patients with cerebral hemorrhage were normal antithrombin III levels and slightly decreased
alpha 2-plasmin inhibitor
. These imply the fact of increased fibrinolytic activities. It is suggested that increased fibrinolysis are secondary reaction of cerebral hemorrhage. 3) Findings from patients with subarachnoid hemorrhage showed hypercoagulable state and increased fibrinolytic activities. It is considered that subarachnoid hemorrhage might have mostly a preparatory condition of
disseminated intravascular coagulation
among cerebrovascular accidents.
...
PMID:[Correlation between coagulation and fibrinolysis in patient with cerebrovascular accident at acute stage]. 715 Apr 48
We had rare opportunities to examine changes in fibrin degradation products (FDP)-D-dimer (DD), thrombin-antithrombin III complex (TAT), plasmin-
alpha 2-plasmin inhibitor
complex (PIC) and other coagulation parameters during the clinical courses of living-related partial liver transplantation (LRPLT). In seven out of eight recipients without severe rejection and/or
disseminated intravascular coagulation
(
DIC
), FDP-DD values reached their maximum at 5 to 10 days after transplantation, then gradually decreased. On the other hand, TAT values rose to the maximum at anhepatic or reperfusion phase of liver transplantation. These data represent hypercoagulation in consequence of tissue thromboplastin activation after extensive operation. Changes in PIC, tissue-type plasminogen activator, and plasminogen activator inhibitor-1 (PAI-1) in the clinical course of case 1 suggested that fibrinolysis was suppressed by relatively elevated level of PAI-1 around the operation, but thereafter was adversely accelerated by relatively lower levels of PAI-1. In comparison with patients with
DIC
, TAT was much higher but PIC was significantly lower in recipients of LRPLT. These findings indicated that marked hypercoagulation and mild to moderate hyperfibrinolysis occurred in recipients of LRPLT.
...
PMID:[Changes in coagulation parameters during the clinical courses of recipients of living-related partial liver transplantation]. 747 43
Antigen levels of blood coagulation factor XIII (XIII) were determined in plasmas from patients with increased levels of fibrin degradation products-D-dimer (FDP-DD), including
disseminated intravascular coagulation
(
DIC
), by latex photometric immunoassay using polyclonal anti-XIII a subunit antibody-coated latex reagent. Since stable fibrin is directly degradated by plasmin and FDP-DD is produced, plasma FDP-DD levels correlate with plasmin-
alpha 2-plasmin inhibitor
complex levels, but not with thrombin-antithrombin III complex (TAT) or XIII levels. In order to clarify other causes of discordant relationships among the related three parameters, we studied the changes in plasma XIII, TAT and FDP-DD levels in fourteen
DIC
patients induced by various primary disorders. Only in two cases, XIII levels changed up and down irrelevant to the fluctuating levels of TAT and FDP-DD. In seven cases, plasma XIII levels remained low during the clinical courses, indicating possibilities that elevated condition of XIII consumption continued and/or production of XIII was low. On the other hand, in four patients, including two patients with nephrosis, XIII might be produced at higher rate than that of consumption. Same phenomenon was observed in one of eight recipients with living-related liver transplantation who showed remarkably increased levels of FDP-DD without
DIC
. In conclusion, plasma XIII level in patients with elevated FDP-DD may be influenced by the balance between consumption of XIII by unstable fibrin and/or surgical stress and the following tissue recovery etc. and production of XIII in liver, megakaryocytes and monocytes.
...
PMID:[Studies on the blood coagulation factor XIII in patients with increased levels of FDP D-dimer]. 774 33
Plasma levels of thrombin-antithrombin III complex (TAT), plasmin-
alpha 2-plasmin inhibitor
complex (PIC) and active plasminogen activator inhibitor (PAI) were assayed in 66 cases of
disseminated intravascular coagulation
(
DIC
). Significant elevation of both TAT and PIC was observed in all cases of
DIC
. Most elevated levels of TAT were seen in
DIC
with acute promyelocytic leukaemia (APL) and sepsis. The highest levels of PIC were seen in
DIC
with APL but were much lower in sepsis. A significant elevation in active PAI was observed in
DIC
due to acute leukaemia (apart from APL), chronic myeloid leukaemia and sepsis, but not in APL, non-Hodgkin lymphoma and cancer. Active PAI was higher in patients with multiple organ failure (MOF) than in those without MOF while PIC was lower in patients with this complication. Thus, the balance of coagulation and fibrinolysis varied according to the underlying cause of
DIC
; APL had more dominant activation of fibrinolysis, while sepsis had greater activation of coagulation. It is suggested that the inhibition of secondary fibrinolytic activation plays an important role in the progression of MOF by the disturbance of the microcirculation.
...
PMID:Study of the balance between coagulation and fibrinolysis in disseminated intravascular coagulation using molecular markers. 786 91
Recently it has been shown that tissue factor (TF), an important trigger for initiating blood coagulation, is present in the circulating plasma. In order to assess the clinical implications of TF in plasma, plasma concentration of TF was quantitated in 65 patients with
disseminated intravascular coagulation
(
DIC
). The mean concentration of plasma TF was elevated in patients with
DIC
at presentation as compared with healthy subjects (446 +/- SD 536 pg/ml vs. 138 +/- 51 pg/ml, P < 0.001). Abnormally high levels were found only in 46.2% of the patients, predominantly in patients with non-hematological solid tumors and acute leukemia. Plasma TF did not correlate with hemostatic markers of
DIC
such as thrombin-antithrombin III complex, prothrombin fragment 1 + 2, plasma-
alpha 2-plasmin inhibitor
complex, FDP, D-dimer, or fibrinogen. Serial determinations of plasma TF demonstrated that plasma TF changes roughly in parallel with the course of
DIC
in most patients with elevated TF at presentation of
DIC
. These findings suggest that plasma TF is potentially valuable for monitoring the progress of
DIC
in a limited population of patients.
...
PMID:Tissue factor in plasma of patients with disseminated intravascular coagulation. 803 86
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