Sunday, January 16, 2011

Major Disorders Associated with Disseminated Intravascular Coagulation.

Obstetric Complications

Abruptio placentae
Retained dead fetus
Septic abortion
Amniotic fluid embolism
Toxemia

Infections

Gram-negative sepsis
Meningococcemia
Rocky Mountain spotted fever
Histoplasmosis
Aspergillosis
Malaria

Neoplasms

Carcinomas of pancreas, prostate, lung, and stomach
Acute promyelocytic leukemia

Massive Tissue Injury

Traumatic
Burns
Extensive surgery

Miscellaneous

Acute intravascular hemolysis, snakebite, giant hemangioma, shock, heat stroke, vasculitis, aortic aneurysm, liver disease

Clinical Course:

1)Acute DIC – mainly presents as a bleeding diathesis. shock, with acute renal failure, dyspnea, cyanosis, convulsions, and coma. Hypotension is characteristic. petechiae and ecchymoses on the skin. severe hemorrhage into the gut or urinary tract.
Waterhouse-Friderichsen syndrome – microthrombi in glomeruli may lead to microinfarct in renal cortex – in severe cases can cause renal cortical necrosis, and involvement of adrenal glands in severe cases is known as WF syndrome.
Microinfarcts in the brain may give rise to bizarre neurologic signs.
2) Chronic DIC - tends to present as thrombotic complications.

Laboratory evaluation

Thrombocytopenia
PT and PTT – prolonged
Fibrin split products are increased in the plasma.


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