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Disseminated intravascular coagulopathy

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https://www.readbyqxmd.com/read/29348275/microangiopathies-in-pregnancy
#1
Jailan Elayoubi, Kavitha Donthireddy, Divyesh Reddy Nemakayala
Thrombotic thrombocytopenic purpura (TTP) is a potentially reversible, life-threatening medical emergency. We present a case of a 21-year-old female with evidence of haemolytic anaemia based on the presence of positive markers of haemolysis. Negative Coomb's test, thrombocytopenia and placental infarcts raised suspicion for a thrombotic microangiopathy. She was diagnosed with TTP and managed with emergency plasma exchange. Her recovery was immediate.A presumptive diagnosis of TTP should be based on the presence of microangiopathic haemolytic anaemia with thrombocytopenia and plasma exchange should be initiated while complete work up is pending...
January 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29346034/coagulopathy-in-severe-sepsis-interconnectivity-of-coagulation-and-the-immune-system
#2
Jason M Samuels, Hunter B Moore, Ernest E Moore
BACKGROUND: Disseminated intravascular coagulation (DIC) remains a challenging complication of infection with inadequate treatment and significant morbidity and mortality rates. METHODS: Review of the English-language literature. RESULTS: Disseminated intravascular coagulation arises from the immune system's response to microbial invasion, as well as the byproducts of cell death that result from severe sepsis. This response triggers the coagulation system through an interconnected network of cellular and molecular signals, which developed originally as an evolutionary mechanism intended to isolate micro-organisms via fibrin mesh formation...
January 18, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29248323/staphylococcal-scalded-skin-syndrome-an-uncommon-symptomatology-revealing-an-immune-deficiency
#3
H Ajmi, N Jemmali, S Mabrouk, S Hassayoun, M Ben-Ali, M-R Barbouche, M Mokni, S Abroug
Primary immune deficiencies associated with hyper-IgE syndrome are rare diseases with clinical features dominated by recurring cutaneous and visceral bacterial infections, particularly infections due to Staphylococcus species. Most of these infections are associated with milder inflammation compared to normal. We report a primary immune deficiency associated with a hyper-IgE syndrome revealed by a staphylococcal scalded skin syndrome in a 5-year-old girl. The patient presented with a severe staphylococcal infection with extensive skin lesions and disseminated intravascular coagulation...
December 13, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29233830/placental-abruption-leading-to-hysterectomy
#4
Hannah Catherine Sylvester, Madeleine Stringer
A 32-year-old multigravid patient at 21 weeks gestation presents with major concealed placental abruption and subsequent fetal demise. During an eventually failed misoprostol regime aiming for vaginal delivery she develops severe disseminated intravascular coagulopathy. Subsequent hysterotomy reveals Couvelaire uterus with major haemorrhage and requires subtotal hysterectomy for haemostasis. This case highlights the severity of the systemic response to abruption and fetal demise in utero and the multifactorial nature of its management...
December 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29232592/the-impact-of-oral-arsenic-and-all-trans-retinoic-acid-on-coagulopathy-in-acute-promyelocytic-leukemia
#5
Hong-Hu Zhu, Zhi-Ping Guo, Jin-Song Jia, Qian Jiang, Hao Jiang, Xiao-Jun Huang
The aim of our study was to evaluate the impact of oral arsenic (the realgar-indigo naturalis formula, RIF) and all-trans retinoic acid (ATRA) on coagulopathy in acute promyelocytic leukemia (APL) compared with intravenous arsenic trioxide (ATO) and ATRA during induction. Mitoxantrone was added to all the patients at a dose of 1.4mg/m2 per day for 5-7 days. D-dimer levels, prothrombin time (PT), fibrinogen (Fbg) levels and the platelet count were comparably analyzed among 83 newly diagnosed APL patients treated with RIF (n=45) or with ATO (n=38)...
November 15, 2017: Leukemia Research
https://www.readbyqxmd.com/read/29222696/thrombomodulin-favors-leukocyte-microvesicle-fibrinolytic-activity-reduces-netosis-and-prevents-septic-shock-induced-coagulopathy-in-rats
#6
Julie Helms, Raphaël Clere-Jehl, Elsa Bianchini, Pierrick Le Borgne, Mélanie Burban, Fatiha Zobairi, Jean-Luc Diehl, Lelia Grunebaum, Florence Toti, Ferhat Meziani, Delphine Borgel
BACKGROUND: Septic shock-induced disseminated intravascular coagulation is responsible for increased occurrence of multiple organ dysfunction and mortality. Immunothrombosis-induced coagulopathy may contribute to hypercoagulability. We aimed at determining whether recombinant human thrombomodulin (rhTM) could control exaggerated immunothrombosis by studying procoagulant responses, fibrinolysis activity borne by microvesicles (MVs) and NETosis in septic shock. METHODS: In a septic shock model after a cecal ligation and puncture-induced peritonitis (H0), rats were treated with rhTM or a placebo at H18, resuscitated and monitored during 4 h...
December 8, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/29215847/-pathogenic-peculiarities-of-disseminated-intravascular-coagulation-of-various-ethiology
#7
E V Guzovskaya, S N Serebrennikova
DIC is a severe complication, often resulting in multi-organ failure and fatal outcome. As any syndrome, it is polyethiologic, while a big number of its causes logically leads to various mechanisms of its forming. Main manifestations of the disseminated intravascular blood coagulation syndrome are clottage and haemorrhage. A result of a massive clottage in microcirculatory bed of internal organs is development of dystrophic changes in them and organ failure. Haemorrhage in its turn, results in decreased volume of circulating blood, arterial hypotension and hemic hypoxia, in most severe cases leading to the fatal outcome...
April 2017: Patologicheskaia Fiziologiia i èksperimental'naia Terapiia
https://www.readbyqxmd.com/read/29197958/immunohaemostasis-a-new-view-on-haemostasis-during-sepsis
#8
REVIEW
Xavier Delabranche, Julie Helms, Ferhat Meziani
Host infection by a micro-organism triggers systemic inflammation, innate immunity and complement pathways, but also haemostasis activation. The role of thrombin and fibrin generation in host defence is now recognised, and thrombin has become a partner for survival, while it was seen only as one of the "principal suspects" of multiple organ failure and death during septic shock. This review is first focused on pathophysiology. The role of contact activation system, polyphosphates and neutrophil extracellular traps has emerged, offering new potential therapeutic targets...
December 2, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/29132978/intensive-care-in-severe-malaria-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#9
REVIEW
Dilip R Karnad, Mohd Basri Mat Nor, Guy A Richards, Tim Baker, Pravin Amin
Severe malaria is common in tropical countries in Africa, Asia, Oceania and South and Central America. It may also occur in travelers returning from endemic areas. Plasmodium falciparum accounts for most cases, although P vivax is increasingly found to cause severe malaria in Asia. Cerebral malaria is common in children in Africa, manifests as coma and seizures, and has a high morbidity and mortality. In other regions, adults may also develop cerebral malaria but neurological sequelae in survivors are rare...
November 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29102830/prognostic-significance-of-a-prolonged-international-normalized-ratio-in-elderly-patients-in-an-internal-medicine-ward
#10
Galina Plotnikov, Lior Bracha, Shimon Izhakian, Moshe Tishler, Oleg Gorelik
PURPOSE: To investigate clinical characteristics and the prognostic significance of a prolonged international normalized ratio (INR) without obvious cause or anticoagulant treatment, in elderly inpatients. METHODS: Demographic, clinical, and laboratory data, in-hospital death and 30day-mortality were prospectively registered for 100 consecutive patients aged ≥75years admitted to an internal medicine ward for a variety of acute medical disorders, and compared according to normal (≤1...
October 31, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29078927/acquired-bleeding-disorders
#11
REVIEW
Alisheba Hurwitz, Richard Massone, Bernard L Lopez
Emergency medicine practitioners treat bleeding patients on a regular basis. Disorders of hemostasis are an additional challenge in these patients but can be assessed and managed in a systematic fashion. Of particular importance to the emergency clinician are the iatrogenic causes of abnormal hemostasis. Other acquired causes of abnormal hemostasis include renal disease, immune thrombocytopenia, thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, acquired coagulation factor inhibitors, acute traumatic coagulopathy, liver disease, and disseminated intravascular coagulopathy...
December 2017: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/29077660/successful-resuscitation-of-maternal-cardiac-arrest-with-disseminated-intravascular-coagulation-guided-by-rotational-thromboelastometry-and-transesophageal-echocardiography-a-case-report
#12
Hannah Brown, Helen L Barrett, Julie Lee, Jason M Pincus, Rebecca M Kimble, Victoria A Eley
We present a case of maternal cardiac arrest during an elective cesarean delivery. Transesophageal echocardiography identified a large pulmonary artery mass, and guided resuscitation efforts. After return of spontaneous circulation, the patient developed disseminated intravascular coagulation with massive hemorrhage. Blood product selection and volume replacement were guided by rotational thromboelastometry and transesophageal echocardiography, respectively. Correction of coagulopathy was observed clinically and confirmed by rotational thromboelastometry...
October 26, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29077164/macrophage-activation-syndrome-as-a-complication-of-juvenile-rheumatoid-arthritis
#13
Q An, M-W Jin, X-J An, S-M Xu, L Wang
OBJECTIVE: Juvenile rheumatoid arthritis (JRA), also known as juvenile idiopathic arthritis (JIA), is a rare autoimmune joint disorder of children. The concrete causes for the prevalence of the above pathological state are still unknown. In other words, it is an arthritis affecting mainly children and adolescents. Clinically, it has 3 different clinical subtypes. JRA patients are often noticed with some confirmed symptoms including coagulopathy, disseminated intravascular coagulation (DIC) with hepatosplenomegaly, fall in erythrocyte sedimentation rate and higher levels of liver enzymes leading to a life-threatening outcome...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29055789/in-vitro-studies-on-the-role-of-recombinant-human-soluble-thrombomodulin-in-the-context-of-retinoic-acid-mediated-apl-differentiation-syndrome
#14
Shinsuke Kojima, Chie Nishioka, SungGi Chi, Akihito Yokoyama, Takayuki Ikezoe
Recombinant human soluble thrombomodulin (rTM) is a newly developed anti-coagulant approved for treatment of disseminated intravascular coagulation (DIC) in Japan. rTM exerts anti-inflammatory and cytoprotective functions via its lectin-like and epidermal growth factor-like domains, respectively. In this study, we retrospectively reviewed the treatment of 21 consecutive patients with coagulopathy, complicated by acute promyelocytic leukemia (APL), with all-trans retinoic acid (ATRA) with or without combination with rTM...
October 18, 2017: Leukemia Research
https://www.readbyqxmd.com/read/29039097/in-vitro-assessment-of-nanoparticle-effects-on-blood-coagulation
#15
Timothy M Potter, Jamie C Rodriguez, Barry W Neun, Anna N Ilinskaya, Edward Cedrone, Marina A Dobrovolskaia
Blood clotting is a complex process which involves both cellular and biochemical components. The key cellular players in the blood clotting process are thrombocytes or platelets. Other cells, including leukocytes and endothelial cells, contribute to clotting by expressing the so-called pro-coagulant activity (PCA) complex on their surface. The biochemical component of blood clotting is represented by the plasma coagulation cascade, which includes plasma proteins also known as coagulation factors. The coordinated interaction between platelets, leukocytes, endothelial cells, and plasma coagulation factors is necessary for maintaining hemostasis and for preventing excessive bleeding...
2018: Methods in Molecular Biology
https://www.readbyqxmd.com/read/29035656/clinical-laboratory-and-hemostatic-findings-in-cats-with-naturally-occurring-sepsis
#16
Sigal Klainbart, Limor Agi, Tali Bdolah-Abram, Efrat Kelmer, Itamar Aroch
OBJECTIVE To characterize clinical and laboratory findings in cats with naturally occurring sepsis, emphasizing hemostasis-related findings, and evaluate these variables for associations with patient outcomes. DESIGN Prospective, observational, clinical study. ANIMALS 31 cats with sepsis and 33 healthy control cats. PROCEDURES Data collected included history; clinical signs; results of hematologic, serum biochemical, and hemostatic tests; diagnosis; and outcome (survival vs death during hospitalization or ≤ 30 days after hospital discharge)...
November 1, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/29028771/mechanisms-of-thrombocytopenia-during-septic-shock-a-multiplex-cluster-analysis-of-endogenous-sepsis-mediators
#17
Alexandre Bedet, Keyvan Razazi, Florence Boissier, Mathieu Surenaud, Sophie Hue, Stéphane Giraudier, Christian Brun-Buisson, Armand Mekontso Dessap
BACKGROUND: Thrombocytopenia is a common feature of sepsis and may involve various mechanisms often related to the inflammatory response. This study aimed at evaluating factors associated with thrombocytopenia during human septic shock. In particular, we used a multiplex analysis to assess the role of endogenous sepsis mediators. METHODS: Prospective, observational study. Thrombocytopenia was defined as an absolute platelet count <100 G/L or a 50% relative decrease in platelet count during the first week of septic shock...
October 12, 2017: Shock
https://www.readbyqxmd.com/read/28986851/protocols-to-assess-coagulation-following-in-vitro-infection-with-hemorrhagic-fever-viruses
#18
Melissa L Tursiella, Shannon L Taylor, Connie S Schmaljohn
During the course of infection with a hemorrhagic fever virus (HFV), the checks and balances associated with normal coagulation are perturbed resulting in hemorrhage in severe cases and, in some patients, disseminated intravascular coagulopathy (DIC). While many HFVs have animal models that permit the analyses of systemic coagulopathy, animal infection models do not exist for all HFVs and moreover do not always recapitulate the pathology observed in human tissues. Furthermore, molecular analyses of how coagulation is affected are not always straightforward or practical when using ex-vivo animal-derived samples, thus reinforcing the importance of cell culture studies...
2018: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28963294/new-criteria-for-sepsis-induced-coagulopathy-sic-following-the-revised-sepsis-definition-a-retrospective-analysis-of-a-nationwide-survey
#19
Toshiaki Iba, Marcello Di Nisio, Jerrold H Levy, Naoya Kitamura, Jecko Thachil
OBJECTIVE: Recent clinical studies have shown that anticoagulant therapy might be effective only in specific at-risk subgroups of patients with sepsis and coagulation dysfunction. The definition of sepsis was recently modified, and as such, old scoring systems may no longer be appropriate for the diagnosis of sepsis-associated coagulopathy. The aim of this study was to evaluate prognostic factors in patients diagnosed with sepsis and coagulopathy according to the new sepsis definition and assess their accuracy in comparison with existing models...
September 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28961562/maternal-death-due-to-amniotic-fluid-embolism-a-national-study-in-france
#20
Marie-Pierre Bonnet, Diane Zlotnik, Monica Saucedo, Dominique Chassard, Marie-Hélène Bouvier-Colle, Catherine Deneux-Tharaux
BACKGROUND: A structured definition of amniotic fluid embolism (AFE) based on 4 criteria was recently proposed for use in research by the Society for Maternal-Fetal Medicine (SMFM) and the Amniotic Fluid Embolism Foundation. The main objective of this study was to review all AFE-related maternal deaths in France during 2007-2011 according to the presence or not of all these 4 diagnostic criteria. METHODS: Maternal deaths due to AFE were identified by the national experts committee of the French Confidential Enquiry into Maternal Deaths during 2007-2011 (n = 39)...
January 2018: Anesthesia and Analgesia
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