16,994 results match your criteria Disseminated Intravascular Coagulation

Purpura fulminans due to bacteraemia in an unsplectomised immunocompetent adult without primary hypocomplementaemia.

BMJ Case Rep 2022 May 19;15(5). Epub 2022 May 19.

Internal Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, USA.

Invasive pneumococcal disease occurs in high-risk patient population which includes patients with asplenia and primary hypocomplementaemia. Pneumococcal sepsis can rarely cause disseminated intravascular coagulation (DIC) and intravascular thrombosis of small and medium sized vessels called purpura fulminans which is associated with a high mortality rate. We present the case of an immunocompetent woman in her 50s with an intact spleen who presented with septic shock from bacteraemia. Read More

View Article and Full-Text PDF

Thrombin generation capacity is enhanced by low antithrombin activity and depends on the activity of the related coagulation factors.

Thromb J 2022 May 18;20(1):29. Epub 2022 May 18.

Sysmex Corporation, 4-4-4 Takatsukadai, Nishi-ku, Kobe, 651-2271, Japan.

Background: Supplementation with antithrombin (AT) concentrates is now common in the treatment of congenital and acquired AT deficiency. However, there is no established consensus on the target and timing of supplementation. We aimed to elucidate the effects of AT deficiency on the balance between coagulation activation and inhibition using a thrombin generation assay as in vitro global assay. Read More

View Article and Full-Text PDF

How to approach haemolysis: Haemolytic anaemia for the general physician.

Clin Med (Lond) 2022 May;22(3):210-213

King's College Hospital, London, UK.

Haemolytic anaemia can seem like a complicated topic. The constellation of reticulocytosis, increased lactate dehydrogenase levels, increased unconjugated bilirubin levels and decreased haptoglobin levels should prompt general physicians to consider haemolysis as a differential diagnosis. When further approaching haemolytic anaemia, subdividing patients into those who are 'direct antiglobulin test (DAT) positive' (immune) or 'DAT negative' (non-immune) is a simple and clinically relevant way to start to formulate a cause for the haemolytic anaemia. Read More

View Article and Full-Text PDF

Thrombocytopenia: the good, the bad and the ugly.

Clin Med (Lond) 2022 May;22(3):214-217

University Hospitals Sussex NHS Foundation Trust, Brighton, UK and Brighton and Sussex Medical School, Falmer, UK.

New thrombocytopenia may be associated with a variety of conditions and diagnosis can be challenging. Presentation can vary from life-threatening bleeding or thrombosis to an incidental finding in an asymptomatic patient. New thrombocytopenia requires urgent investigation. Read More

View Article and Full-Text PDF

Thromboelastography for Predicting Disseminated Intravascular Coagulation (DIC) in Sepsis.

Shock 2022 May;57(5):759

Department of Critical Care Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India.

View Article and Full-Text PDF

Diagnosis and management of severe congenital protein C deficiency (SCPCD): Communication from the SSC of the ISTH.

J Thromb Haemost 2022 Apr 17. Epub 2022 Apr 17.

Departments of Pathology & Immunology, Pediatrics, and Medicine, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA.

Severe congenital protein C deficiency (SCPCD) is rare and there is currently substantial variation in the management of this condition. A joint project by three Scientific and Standardization Committees of the ISTH: Plasma Coagulation Inhibitors, Pediatric/Neonatal Thrombosis and Hemostasis, and Women's Health Issues in Thrombosis and Hemostasis, was developed to review the current evidence and help guide on diagnosis and management of SCPCD. We provide a summary of the clinical presentations, differential diagnoses, appropriate investigations to confirm the diagnosis, approaches for management of the acute situation, and options for long-term management including subsequent pregnancies. Read More

View Article and Full-Text PDF

Venovenous Extracorporeal Membrane Oxygenation in Diffuse Alveolar Hemorrhaging Secondary to Anti-neutrophil Cytoplasmic Autoantibody-associated Vasculitis: Starting without Systemic Anticoagulation.

Intern Med 2022 May 14. Epub 2022 May 14.

Emergency and Critical Care Center, Tokyo Metropolitan Tama Medical Center, Japan.

Regarding extracorporeal membrane oxygenation (ECMO) support against hemorrhagic conditions, there seems to be a dilemma when deciding between maintaining the circuit patency by systemic anticoagulation and increasing the risk of bleeding. We herein report two cases of diffuse alveolar hemorrhaging (DAH) caused by myeloperoxidase (MPO) anti-neutrophil cytoplasmic autoantibody-associated vasculitis (AAV) successfully treated with venovenous (VV)-ECMO support, both initially started without systemic anticoagulation. Under anticoagulation-free ECMO management, we should consider the shortcomings of frequent circuit exchange and hemorrhagic diathesis related to circuit-induced disseminated intravascular coagulation (DIC). Read More

View Article and Full-Text PDF

Innate immune signalling and immunothrombosis: New insights and therapeutic opportunities.

Eur J Immunol 2022 May 15. Epub 2022 May 15.

School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland.

Activation of the coagulation cascade is a critical, evolutionarily conserved mechanism that maintains haemostasis by rapidly forming blood clots in response to blood-borne infections and damaged blood vessels. Coagulation is a key component of innate immunity since it prevents bacterial dissemination and can provoke inflammation. The term immunothrombosis describes the process by which the innate immune response drives aberrant coagulation, which can result in a lethal condition termed disseminated intravascular coagulation, often seen in sepsis. Read More

View Article and Full-Text PDF

Unilateral uterine artery embolization and Bakri tamponade balloon insertion in the treatment of acute puerperal uterine inversion: a case report.

J Med Case Rep 2022 May 14;16(1):190. Epub 2022 May 14.

Department of Obstetrics and Gynaecology, University Hospital Mizonokuchi, Teikyo University School of Medicine, 5-1-1 Futago, Takatsu-ku, Kawasaki, Kanagawa, 213-8507, Japan.

Background: Acute puerperal uterine inversion is rare but may cause massive postpartum blood loss due to uterine atony. Therefore, these patients must be diagnosed, and uterine replacement must be performed as soon as possible. However, in some cases, active bleeding due to uterine atony becomes uncontrollable, even though the uterine inversion itself is treated. Read More

View Article and Full-Text PDF

Decreasing Plasma Fibrinogen Levels in the Intensive Care Unit Are Associated with High Mortality Rates In Patients With Sepsis-Induced Coagulopathy.

Clin Appl Thromb Hemost 2022 Jan-Dec;28:10760296221101386

Department of Critical and Intensive Care Medicine, 13051Shiga University of Medical Science, Otsu, Shiga, Japan.

Plasma fibrinogen levels increase in response to infection, but they could also decrease due to degradation as in severe coagulopathy. We evaluated 60 septic patients with their CRP levels over 5.00 mg/dL. Read More

View Article and Full-Text PDF

[Infectious causes and management of Japanese spotted fever and severe fever thrombocytopenia syndrome in Ehime prefecture].

Naoaki Tomita

Nihon Koshu Eisei Zasshi 2022 May 12. Epub 2022 May 12.

Ehime Prefecture Nanyo Regional Office, Department of Health, Welfare and Environment, Uwajima Public Health Center.

Objectives We investigated the infectious causes and management of Japanese spotted fever (JSF) and severe fever thrombocytopenia syndrome (SFTS), which are usually tick-borne infections, at a public health center in Ehime prefecture.Methods The doctor diagnosing JSF and SFTS at the public health center reported the infectious cases using the questionnaire based on the Ehime Epidemiological Surveillance of Infectious Diseases Program.Results There were 91 cases of JSF reported from August 2003, accounting for 56. Read More

View Article and Full-Text PDF

Oxygen therapy for sepsis and prevention of complications.

Hayk Minasyan

Acute Crit Care 2022 Mar 17. Epub 2022 Mar 17.

Patients with sepsis have a wide range of respiratory disorders that can be treated with oxygen therapy. Experimental data in animal sepsis models show that oxygen therapy significantly increases survival, while clinical data on the use of different oxygen therapy protocols are ambiguous. Oxygen therapy, especially hyperbaric oxygenation, in patients with sepsis can aggravate existing oxidative stress and contribute to the development of disseminated intravascular coagulation. Read More

View Article and Full-Text PDF

Retiform Purpura of the Lower Limbs Associated with Levamisole-Adulterated Cocaine.

Eur J Case Rep Intern Med 2022 28;9(4):003353. Epub 2022 Apr 28.

Department of Dermatology, Mater Dei Hospital, Msida, Malta.

A young man was treated in hospital for sepsis, disseminated intravascular coagulation and multi-organ failure. He was a regular intranasal cocaine user up to 1 day prior to symptom onset. Clinical examination revealed extensive retiform purpura affecting both his lower limbs. Read More

View Article and Full-Text PDF

Treatment of vaccine-induced immune thrombotic thrombocytopenia (VITT).

Semin Hematol 2022 Apr 7;59(2):89-96. Epub 2022 Mar 7.

Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada; McMaster Center for Transfusion Research, McMaster University, Hamilton, Ontario, Canada; Service of Benign Hematology, Department of Medicine, Hamilton Health Sciences, Hamilton, Ontario Canada; Department of Pathology and Molecular Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada; Transfusion Medicine, Hamilton Regional Laboratory Medicine Program, Hamilton, Ontario, Canada. Electronic address:

Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a novel prothrombotic disorder characterized by thrombosis, thrombocytopenia, and disseminated intravascular coagulation identified in hundreds of recipients of ChAdOx1 nCoV-19 (Oxford/AstraZeneca), an adenovirus vector coronavirus disease 2019 (COVID-19) vaccine. VITT resembles heparin-induced thrombocytopenia (HIT) in that patients have platelet-activating anti-platelet factor 4 antibodies; however, whereas heparin typically enhances platelet activation by HIT antibodies, VITT antibody-induced platelet activation is often inhibited in vitro by pharmacological concentrations of heparin. Further, the thrombotic complications in VITT feature much higher frequencies of atypical thrombosis, most notably cerebral vein thrombosis and splanchnic vein thrombosis, compared with HIT. Read More

View Article and Full-Text PDF

Epidemiology of VITT.

Menaka Pai

Semin Hematol 2022 Apr 8;59(2):72-75. Epub 2022 Feb 8.

McMaster University, Hamilton Health Sciences, Hamilton Regional Laboratory Medicine Program, Hamilton, Ontario, Canada. Electronic address:

Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a life-threatening syndrome of aggressive thrombosis, often profound thrombocytopenia, and frequently overt disseminated intravascular coagulation. It has been associated with 2 adenovirus vector COVID-19 vaccines: ChAdOx1 nCoV-19 (AstraZeneca) and Ad26.COV2. Read More

View Article and Full-Text PDF

Platelet-activating anti-PF4 disorders: An overview.

Semin Hematol 2022 Apr 20;59(2):59-71. Epub 2022 Feb 20.

Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada; Transfusion Medicine, Hamilton Regional Laboratory Medicine Program, Hamilton, ON, Canada; Service of Benign Hematology, Hamilton Health Sciences, Hamilton General Hospital, Hamilton, ON, Canada; McMaster Center for Transfusion Research, McMaster University, Hamilton, ON, Canada. Electronic address:

Platelet factor 4 (PF4) is a highly cationic tetrameric protein that can be targeted by platelet-activating anti-PF4 antibodies of immunoglobulin G (IgG) class. Certain features of PF4, including its multivalent nature (duplicate antigen sites per tetramer), the ability of many PF4 tetramers to undergo close approximation through charge neutralization, and the dimeric binding of IgG molecules, results in formation of IgG-containing immune complexes in situ on platelets, neutrophils, and monocytes, resulting in Fcγ receptor-mediated pancellular activation that also activates hemostasis (potential for disseminated intravascular coagulation). This review discusses 4 anti-PF4 disorders: classic heparin-induced thrombocytopenia ([HIT]; triggered by heparin and certain other polyanionic pharmaceuticals, featuring predominantly heparin-dependent antibodies), autoimmune HIT (aHIT; severe subtype of HIT that features both heparin-dependent and heparin-independent platelet-activating antibodies), and spontaneous HIT (non-heparin triggers such as knee replacement surgery and infection; predominantly heparin-independent platelet-activating antibodies). Read More

View Article and Full-Text PDF

Venous sinus thrombosis secondary to disseminated intravascular coagulation after Clostridioides difficile infection.

Neurologia (Engl Ed) 2022 Apr 30. Epub 2022 Apr 30.

Servicio de Neurología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain.

View Article and Full-Text PDF

A Case of Childhood Severe Paroxysmal Cold Hemoglobinuria with Acute Renal Failure Successfully Treated with Plasma Exchange and Eculizumab.

Case Rep Pediatr 2022 22;2022:3267189. Epub 2022 Apr 22.

Carilion Children's Pediatric Hematology/Oncology, Carilion Clinic, Roanoke, VA, USA.

We describe the case of a 4-year-old female who presented with sepsis and disseminated intravascular coagulation (DIC), developed ongoing intravascular hemolysis with acute renal failure from suspected pigment-induced acute tubular necrosis necessitating continuous renal replacement therapy (CRRT) for five days followed by four episodes of intermittent hemodialysis (iHD), and was subsequently diagnosed with paroxysmal cold hemoglobinuria (PCH). She was successfully treated with plasma exchange and eculizumab, a humanized monoclonal antibody targeting complement protein C5, and demonstrated significant improvement of hemolysis and recovery of renal function. Read More

View Article and Full-Text PDF

Olive Leaves as a Potential Phytotherapy in the Treatment of COVID-19 Disease; A Mini-Review.

Front Pharmacol 2022 13;13:879118. Epub 2022 Apr 13.

School of Biotechnology, Badr University in Cairo, Badr City, Egypt.

Beginning from December 2019, widespread COVID-19 has caused huge financial misfortunes and exceptional wellbeing emergencies across the globe. Discovering an effective and safe drug candidate for the treatment of COVID-19 and its associated symptoms became an urgent global demand, especially due to restricted information that has been discharged with respect to vaccine efficacy and safety in humans. Reviewing the recent research, olive leaves were selected as a potential co-therapy supplement for the treatment and improvement of clinical manifestations in COVID-19 patients. Read More

View Article and Full-Text PDF

Management of a patient with cardiac arrest, intestinal ischemia necrosis, multiple fractures, hemorrhagic shock, renal failure, disseminated intravascular coagulation, and thrombosis after severe abdominal crush injury: A case report.

Exp Ther Med 2022 Jun 12;23(6):386. Epub 2022 Apr 12.

Center for Disease Control and Prevention, Western Theater Command, Lanzhou, Gansu 730020, P.R. China.

Abdominal crush injury has been widely reported. However, abdominal crush injury cases involving most of the organ systems have seldom been reported. In the present case report, a 58-year-old man was hit in the abdomen by a 4-ton machine tool. Read More

View Article and Full-Text PDF

The Use of Prothrombin Complex Concentrates: Results of a Nationwide Survey of Critical Care Pharmacists.

J Pharm Pract 2022 Apr 14;35(2):197-204. Epub 2020 Oct 14.

Department of Clinical Pharmacy, 15503University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA.

Background: Prothrombin complex concentrates (PCCs) are frequently used.

Objective: To elucidate practices and perceptions of proprietary and nonproprietary PCCs use.

Methods: An electronic pretested cross-sectional survey e-mailed thrice to 1 critical care pharmacist at 1170 US institutions. Read More

View Article and Full-Text PDF

A retrospective analysis of emergency hysterectomy intervention strategy in obstetrics.

Pak J Med Sci 2022 Mar-Apr;38(3Part-I):645-651

Jianying Yan, MD. Department of Obstetrics, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University; No. 18, Daoshan Road, Fuzhou, 350000, Fujian Province, P.R. China.

Objectives: To investigate the indications of obstetric emergency hysterectomy and analyze the clinical effects of subtotal hysterectomy and total hysterectomy.

Methods: We included 247 hospitalized women who had undergone abdominal hysterectomy due to obstetric reasons in Fujian Province Maternity and Child Health Hospital (a provincial class-A hospital) and Ningde People's Hospital (a primary Class-B hospital) between January 2002 and December 2018. We identified surgical indications and clinical characteristics of the patients. Read More

View Article and Full-Text PDF

Role of Salivary Uric Acid Versus Serum Uric Acid in Predicting Maternal Complications of Pre-Eclampsia in a Rural Hospital in Central India: A Two-Year, Cross-Sectional Study.

Cureus 2022 Mar 21;14(3):e23360. Epub 2022 Mar 21.

Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, IND.

Background Hypertensive disorders during pregnancy are an important topic of concern, specifically in rural and remote areas of India where there is a lack of awareness and it is difficult to maintain proper follow-up of pregnant females to screen them for complications developed during pregnancy. Gestational hypertension and pre-eclampsia result in the abruption of the placenta, hemolysis, elevated liver enzymes, low platelet count syndrome, eclampsia, and disseminated intravascular coagulation, which can be a serious threat to the health of the mother and the fetus. Therefore, it is important to identify biomarkers for diagnosing and predicting the complications of pre-eclampsia that may aid the obstetric high-dependency units based in rural areas to tackle this important health hazard during pregnancy. Read More

View Article and Full-Text PDF

Complement Activation in Patients With Heat-Related Illnesses: Soluble CD59 Is a Novel Biomarker Indicating Severity of Heat-Related Illnesses.

Crit Care Explor 2022 Apr 21;4(4):e0678. Epub 2022 Apr 21.

Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Urayasu, Japan.

Objectives: Although multiple organ dysfunction syndrome (MODS) is the main cause of death in patients with heat-related illnesses, its underlying pathophysiological mechanism remains elusive. Complement activation is considered one of the main causes of MODS in patients with sepsis and trauma. Considering the pathophysiological similarity of heat related-illnesses with sepsis and trauma, the complement system might be activated in patients with heat-related illnesses as well. Read More

View Article and Full-Text PDF

Clinical characteristics and treatment of elderly onset adult-onset Still's disease.

Sci Rep 2022 Apr 26;12(1):6787. Epub 2022 Apr 26.

Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Japan.

Adult-onset Still's disease (AOSD)-a systemic inflammatory disease-often occurs at a young age. Recently, elderly onset patient proportion has been increasing; however, data are limited. To evaluate the characteristics of elderly patients with AOSD in a multicenter cohort, we retrospectively analyzed 62 patients with AOSD at five hospitals during April 2008-December 2020. Read More

View Article and Full-Text PDF

Coagulopathy and Traumatic Brain Injury: Overview of New Diagnostic and Therapeutic Strategies.

Neurol Med Chir (Tokyo) 2022 Apr 22. Epub 2022 Apr 22.

Department of Emergency and Critical Care Medicine, Nippon Medical School Hospital.

Coagulopathy is a common sequela of traumatic brain injury. Consumptive coagulopathy and secondary hyperfibrinolysis are associated with hypercoagulability. In addition, fibrinolytic pathways are hyperactivated as a result of vascular endothelial cell damage in the injured brain. Read More

View Article and Full-Text PDF

Thromboelastography maximum amplitude as an early predictor of disseminated intravascular coagulation in patients with heatstroke.

Int J Hyperthermia 2022 ;39(1):605-610

Department of Critical Care Medicine, the 908th Hospital of Chinese Logistical Support Force, Nanchang, China.

Objectives: The aim of this study was to investigate the ability of TEG to predict DIC associated with heatstroke.

Methods: We carried out a retrospective, single-center study of 67 patients with heatstroke admitted to an intensive care unit (ICU) at a comprehensive hospital between July 2016 and August 2021. Conventional coagulation tests (CCTs) and TEG were performed within 2 h of admission in ICU. Read More

View Article and Full-Text PDF

Clinical symptoms associated with fatality of severe fever with thrombocytopenia syndrome: A systematic review and meta-analysis.

Acta Trop 2022 Apr 21;232:106481. Epub 2022 Apr 21.

Department of Microbiological Laboratory Technology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China. Electronic address:

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infection disease that is deadly if left untreated. Identification of potential risk factors with prognosis value may help to focus clinical management and reduce case fatality. However, information about these factors is conflicting and scattered. Read More

View Article and Full-Text PDF

Application of Abdominal Aortic Balloon Occlusion Combined with Tourniquet in Pregnant Women with Severe Placenta Accreta Spectrum.

Curr Med Sci 2022 Apr 23. Epub 2022 Apr 23.

Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430070, China.

Objective: Abdominal aortic balloon occlusion (AABO) is a vascular intervention method that has been widely used in the treatment of severe placenta accreta spectrum (PAS). The aim of this study was to investigate the benefits, potential risks, and characteristics of AABO combined with tourniquet binding of the lower uterine segment (LUS) in treatment of pregnant women with PAS.

Methods: In this study, 64 pregnant women with PAS scores greater than 5 were enrolled as research subjects and divided into two groups. Read More

View Article and Full-Text PDF

Incidence of COVID-19-Associated Venous Thromboembolism Among Hospitalized Patients in McAllen, Texas, USA, in Late 2021.

Cureus 2022 Mar 17;14(3):e23270. Epub 2022 Mar 17.

Internal Medicine, South Texas Health System, McAllen Medical Center, McAllen, USA.

This study investigated the incidence of venous thromboembolism (VTE) in hospitalized COVID-19 patients in a community hospital in McAllen, Texas, USA. Such incidence was reported to be as high as 31% in early 2020, and in the range of 3.1%-13. Read More

View Article and Full-Text PDF