• Title/Summary/Keyword: Disseminated intravascular coagulation

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Respiratory Syncytial Virus Infection Complicated by Extrapulmonary Manifestations (폐외증상을 동반한 호흡기세포융합바이러스 감염 1예)

  • Jung, Jae Ho;Kim, Yun Kyum;Choi, Hee Joung
    • Pediatric Infection and Vaccine
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    • v.24 no.3
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    • pp.188-192
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    • 2017
  • Respiratory syncytial virus (RSV) typically causes lower respiratory tract infections in children, and most patients recover successfully. However, some infants and young children can have a severe course of disease with respiratory failure, and extrapulmonary manifestations can occur in severe RSV disease. We report one case of severe RSV bronchiolitis complicated with acute myocarditis, fulminant hepatic failure, and disseminated intravascular coagulation.

Korean Red Ginseng, a regulator of NLRP3 inflammasome, in the COVID-19 pandemic

  • Jung, Eui-Man;Lee, Geun-Shik
    • Journal of Ginseng Research
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    • v.46 no.3
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    • pp.331-336
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    • 2022
  • Coronavirus disease 2019 (COVID-19) exhibits various symptoms, ranging from asymptomatic to severe pneumonia or death. The major features of patients in severe COVID-19 are the dysregulation of cytokine secretion, pneumonia, and acute lung injury. Consequently, it leads to acute respiratory distress syndrome, disseminated intravascular coagulation, multiple organ failure, and death. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative virus of COVID-19, influences nucleotide-binding oligomerization domain, leucine-rich repeat, and pyrin domain containing 3 (NLRP3), the sensor of inflammasomes, directly or indirectly, culminating in the assembly of NLRP3 inflammasome and activation of inflammatory caspases, which induce the inflammatory disruption in severe COVID-19. Accordingly, the target therapeutics for inflammasome has attracted attention as a treatment for COVID-19. Korean Red Ginseng (KRG) inhibits several inflammatory responses, including the NLRP3 inflammasome signaling. This review discusses the role of KRG in the treatment and prevention of COVID-19 based on its anti-NLRP3 inflammasome efficacy.

Design of 3D printed chip for thrombus measurement and feasibility study for smoking effect (혈전 측정용 3D printed chip 설계 및 흡연의 영향 사전 연구)

  • Haebeen Kim;Eunseop Yeom
    • Journal of the Korean Society of Visualization
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    • v.21 no.1
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    • pp.74-79
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    • 2023
  • Thrombogenesis, which is the process of blood clot formation, can be initiated by platelet activation. Excessive formation of blood clot in the bloodstream can lead to thrombosis. Therefore, when dealing with patients with disseminated intravascular coagulation (DIC) or children, it is necessary to use small amounts of blood. Hence, it is important to develop methods for the rapid and accurate measurement of the platelet function using a small amount of blood. In this study, 3D printing technology was utilized to facilitate the production of micro channels. The amount of platelet adhesion in smokers and non-smokers was compared by repeatedly exposing the structure of the channel to adjust the number of blood injections and facilitate thrombosis attachment to simple stenosis structures.

Disseminated Intravascular Coagulation in Experimental Fowl Cholera of Chickens (닭의 가금(家禽) 콜레라 감염시(感染時)의 파종성(播種性) 혈관내(血管內) 응고증(凝固症))

  • Park, Nam-Yong
    • Korean Journal of Veterinary Research
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    • v.22 no.2
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    • pp.211-219
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    • 1982
  • Chickens from 10 to 32 weeks of age were inoculated with P. multocida via seven routs(intravenous, intramuscular, intraperitoneal, subcutaneous, into ear, intranasal, per oral). The development or distribution of disseminated intravascular coagulation (DIC) in multiple organs and the role of P. multocida endotoxins in disease process of fowl cholera were studied. The histological diagnosis of DIC was made by demonstration of fibrinous in arterioles, capillaries, venules and medium-sized blood vessels. The presence of fibrinous thrombi in blood vessels of multiple organs was observed in chickens which died within approximately 3 days post inoculation. Fibrinous thrombi were observed most frequently in the lung(90% of all cases with DIC) followed by liver (70%), kidney (60%), heart(20%), spleen, brain, pancreas, thymus and thyroid gland. The density of fibrinous thrombi (i.e. the number of thrombi per section) was greatest in the lung, followed by spleen, kidney, liver and heart. It is thought that the widespread hemorrhage of acute fowl cholera is also caused by P. multocida endotoxin which initiates DIC in variety of organs. The cause of death for the chickens after infection with acute fowl cholera is probably due to an endotoxin (septic) shock accompanied with DIC in multiple organs.

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Dabigatran Toxicity Secondary to Acute Kidney Injury (급성신손상으로 인해 발생한 dabigatran 독성)

  • Moon, Hyoung Ho;Lee, Seung Eun;Oh, Dong Jun;Jo, Hee Bum;Kwon, Ki Hwan;Kim, Yoon Jin;Kim, Kyung Soo;Shin, Sung Joon
    • Journal of The Korean Society of Clinical Toxicology
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    • v.12 no.2
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    • pp.92-96
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    • 2014
  • Dabigatran is the first oral direct thrombin inhibitor approved by the US Food and Drug Administration (FDA) for prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. Because dabigatran is excreted mainly by the kidneys, serum levels of dabigatran can be elevated to a supratherapeutic range in patients with renal failure, predisposing to emergent bleeding. We describe the case of a 66-year-old man taking dabigatran 150 mg twice daily for atrial fibrillation and cerebral infarction who presented with hematochezia and disseminated intravascular coagulation. Laboratory evaluation showed a hemoglobin level of 6.3 g/dL, platelets of $138,000/mm^3$, activated partial thromboplastin time (aPTT) of 10 s, and an international normalized ratio (INR) of 8.17. Colonoscopy showed a bleeding anal fissure. Hemostasis was provided by hemoclips and packed red blood cells and fresh frozen plasma were transfused. Since then, there was no further hematochezia, however, bleeding including oral mucosal bleeding, hematuria, and intravenous site bleeding persisted. At presentation, his serum creatinine was 4.96 mg/dL (baseline creatinine, 0.9 mg/dL). Dabigatran toxicity secondary to acute kidney injury was presumed. Because acute kidney injury of unknown cause was progressing after admission, he was treated with hemodialysis. Fresh frozen plasma transfusion was provided with hemodialysis. At 15 days from admission, there was no further bleeding, and laboratory values, including hemoglobin, partial thromboplastin time, and prothrombin time were normalized. He was discharged without bleeding. After 2 months, he undergoes dialysis three times per week and no recurrence of bleeding has been observed.

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Experimental Endotoxin-Induced Disseminated Intravascular Coagulation in Rat Model (쥐 모델에 있어 내독소에 의한 실험적인 범발성 혈관내 응고증)

  • Seok- Cheol Choi;Jai-Young Kim;Jin-Bog Koh;Won-Jae Lee
    • Biomedical Science Letters
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    • v.3 no.2
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    • pp.83-88
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    • 1997
  • In septic patients, disseminated intravascula. coagulation (DIC) occurs frequently and is a pathologic condition associated with a variety of critical illness. DIC may complicate the already complex clinical situations and contribute to the high mortality. Nevertheless, its pathogenic mechanisms are not completely elucidated. Present study was prospectively designed to understand the pathogenetic mechanisms involved in the development of DIC. 15 rats were subjected to study and according to the aim, they were divided into three groups: group I, control (not treated-endotoxin, n=5); group II (12 hours after endotoxin injection, n=5); group III (24 hours after endotoxin injection, n=5). Experimental DIC was induced in rats by a bolus injection of endotoxin (1mg/kg, E. coli serotype 055:B5). Blood was collected by direct puncture of the heart. Platelet count, fibrinogen and plasminogen concentration, antithrombin III, D-dimer and complement components (C3 and C4) were measured in all subjects. In group II and III, there were apparent signs of DIC, including thrombocytopenia, decreased fibrinogen (but increase in group III), reduced C3 and antithrombin III, and elevated D-dimer. These data indicated that endotoxin might induce the activation of several pathways such as coagulation, fibrinolytic and complement cascade, causing DIC and subsequent multiple organ failures. Ultimately, the increased knowledge of the various pathogenetic mechanisms of coagulation activation and fibrinolysis in endotoxin-induced DIC may have prophylactic or therapeutic implications.

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A Case of Trousseau's Syndrome Associated with Lung Cancer (폐암과 동반된 Trousseau 증후군 1예)

  • Song, Min-Kyung;Kim, Young-Sam;Lee, Kee-Myung;Kim, Se-Kyu;Chang, Joon;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.941-946
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    • 1995
  • The association between hypercoagulability and malignant disease was first described by Armand Trousseau in 1865. According to Trousseau, the thrombophlebitis was usually/migratory and recurrent and involved both venous and arterial system. Thrombosis remains the hallmark of Trousseau's syndrome, although a wide variety of coagulation disorders including disseminated intravascular coagulation(DIC), pulmonary embolism, thrombotic endocarditis, and bleeding have been associated with the syndrome. Since then, abnormalities of the coagulation system have been repeatedly demonstrated in patients with cancer. Pancreatic carcinoma is thought to carry the highest risk of Trousseau's syndrome although the number of cases of Trousseau's syndrome is actually higher in patients with lung cancer because of the greater prevalence of this tumor. We report a thirty-five year old male patient with Trousseau's syndrome associated with lung cancer initially presenting deep vein thrombosis.

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A Case of Streptococcus pneumoniae associated Hemolytic Uremic Syndrome with DIC

  • Kim, Seong Heon;Kim, Su Young
    • Childhood Kidney Diseases
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    • v.19 no.1
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    • pp.48-52
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    • 2015
  • Streptococcus pneumoniae associated hemolytic uremic syndrome (SpHUS) is one of the causes of atypical hemolytic uremic syndrome, and increasingly reported. They are more severe and leave more long-term sequelae than more prevalent, typical hemolytic uremic syndrome. But it is not so easy to diagnose SpHUS for several reasons (below), and there was no diagnostic criteria of consensus. A 18 month-old-girl with sudden onset of oliguria and generalized edema was admitted through the emergency room. She had pneumonia with pleural effusion and laboratory findings of HUS, DIC, and positive direct Coombs' test. As DIC or SpHUS was suspected, we started to treat her with broad spectrum antibiotics, transfusion of washed RBC and replacement of antithrombin III. On the $3^{rd}$ day, due to severe hyperkalemia and metabolic acidosis, continuous renal replacement therapy (CRRT) was started. She showed gradual improvement in 4 days on CRRT and discharged in 16 days of hospital care. At the follow up to one year, she has maintained normal renal function without proteinuria and hypertension. We report this case with review of articles including recently suggested diagnostic criteria of SpHUS.

Severe dapsone hypersensitivity syndrome in a child

  • Choi, So Yoon;Hwang, Ho Yeon;Lee, Jung Hyun;Park, Jae Sun;Jang, Min Soo
    • Clinical and Experimental Pediatrics
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    • v.56 no.6
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    • pp.260-264
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    • 2013
  • Dapsone (4,4'-diaminodiphenylsulfone, DDS), a potent anti-inflammatory agent, is widely used in the treatment of leprosy and several chronic inflammatory skin diseases. Dapsone therapy rarely results in development of dapsone hypersensitivity syndrome, which is characterized by fever, hepatitis, generalized exfoliative dermatitis, and lymphadenopathy. Here, we describe the case of an 11-year-old Korean boy who initially presented with high fever, a morbilliform skin rash, generalized lymphadenopathy, hepatosplenomegaly, and leukopenia after 6 weeks of dapsone intake. Subsequently, he exhibited cholecystitis, gingivitis, colitis, sepsis, aseptic meningitis, disseminated intravascular coagulation, syndrome of inappropriate antidiuretic hormone secretion, pneumonia, pleural effusions, peritonitis, bronchiectatic changes, exfoliative dermatitis, and acute renal failure. After 2 months of supportive therapy, and prednisolone and antibiotic administration, most of the systemic symptoms resolved, with the exception of exfoliative dermatitis and erythema, which ameliorated over the following 4 months. Agranulocytosis, atypical lymphocytosis, aseptic meningitis, and bronchiectatic changes along with prolonged systemic symptoms with exfoliative dermatitis were the most peculiar features of the present case.

Successful Damage Control Resuscitation with Resuscitative Endovascular Balloon Occlusion of the Aorta in a Pediatric Patient

  • Heo, Yoonjung;Chang, Sung Wook;Kim, Dong Hun
    • Journal of Trauma and Injury
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    • v.33 no.3
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    • pp.170-174
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    • 2020
  • Resuscitative endovascular balloon occlusion of the aorta (REBOA) is considered an emerging adjunct therapy for profound hemorrhagic shock, as it can maintain temporary stability until definitive repair of the injury. However, there is limited information about the use of this procedure in children. Herein, we report a case of REBOA in a pediatric patient with blunt trauma, wherein the preoperative deployment of REBOA played a pivotal role in damage control resuscitation. A 7-year-old male patient experienced cardiac arrest after a motor vehicle accident. After 30 minutes of cardiopulmonary resuscitation, spontaneous circulation was achieved. The patient was diagnosed with massive hemoperitoneum. REBOA was then performed under ongoing resuscitative measures. An intra-aortic balloon catheter was deployed above the supraceliac aorta, which helped achieved permissive hypotension while the patient was undergoing surgery. After successful bleeding control with small bowel resection for mesenteric avulsion, thorough radiologic evaluations revealed hypoxic brain injury. The patient died from deterioration of disseminated intravascular coagulation. Although the patient did not survive, a postoperative computed tomography scan revealed neither remaining intraperitoneal injury nor peripheral ischemia correlated with the insertion of a 7-Fr sheath. Hence, REBOA can be a successful bridge therapy, and this result may facilitate the further usage of REBOA to save pediatric patients with non-compressible torso hemorrhage.