Disseminated Intravascular Coagulation in Dengue Haemorrhagic Fever

1975 ◽  
Author(s):  
T. Himawan ◽  
L. K. Kho ◽  
S. Melani
Keyword(s):  
Disseminated Intravascular Coagulation ◽  
Bleeding Time ◽  
Dengue Shock Syndrome ◽  
Dengue Haemorrhagic Fever ◽  
Fluid Replacement ◽  
Haemorrhagic Fever ◽  
Laboratory Findings ◽  
Intravascular Coagulation ◽  
Prolonged Bleeding Time ◽  
Fluid Replacement Therapy

The most dreaded complications of dengue fever are haemorrhagic manifestations (Dengue Haemorrhagic Fever) and shock (Dengue Shock Syndrome). We have the opportunity to carry out clinical and haematological studies on 68 selected cases of disseminated intravascular coagulation (DIC) occuring in DHF. Shock was encountered in the majority of the cases (70.6%), while haemorrhagic manifestations were observed in all the children. Other laboratory findings revealed the presence of anemia in 38.1%. hemo-concentration in 72.6% ; the W. B.C. varied between 1,600 and 39,400, thrombocytopenia 83.8%. Fragmented red cells were found in the periferal blood smear. Prolonged bleeding time 69.3%; prolonged clotting time 48.7%; prolonged prothrombine time 66.6%; prolonged partial thromboplastin time 56% ; fibrinogenopenia 80% and positive tourniquet test 85.7%.The management was directed to the improvement of the general condition with intravenous fluid replacement therapy, electrolytes, plasma expanders or blood. Heparin was administered to 36 children with severe DIC. The mortality rate was high (33.8%).

False-Positive D-Dimer Result in a Patient With Castleman Disease

2004 ◽  
Vol 128 (3) ◽  
pp. 328-331
Author(s):  
Kimberly Mugler ◽  
Jerry B. Lefkowitz
Keyword(s):  
Western Blot ◽  
Disseminated Intravascular Coagulation ◽  
False Positive ◽  
Degradation Products ◽  
False Negative ◽  
Castleman Disease ◽  
Laboratory Findings ◽  
Intravascular Coagulation ◽  
Immunodeficiency Virus ◽  
D Dimer

Abstract In suspected cases of disseminated intravascular coagulation, concurrent elevation of both fibrin(ogen) degradation products (FDPs) and D-dimer levels aids in confirming the diagnosis. This pattern of results reflects the action of plasmin proteolysis of cross-linked fibrin polymers as well as fibrinogen. We report the case of a patient with human immunodeficiency virus (HIV) and Castleman disease who presented with a high-positive D-dimer level and a negative FDP level in the course of a workup for disseminated intravascular coagulation. This finding suggested the possibility of either a false-positive D-dimer or a false-negative FDP level. To investigate the former, a Western blot was performed on the patient's serum to determine the presence of the D-dimer. No D-dimer band was visualized on the Western blot, confirming the false-positive nature of the D-dimer result. Insufficient quantity of patient serum, however, prevented further investigation into the etiology of this result. The false-positive D-dimer result is likely attributable to interference caused by the patient's Castleman disease–associated monoclonal gammopathy, a phenomenon that has been reported in other immunoassays. As the development of lymphoproliferative disorders is especially common within the HIV population, and hypergammaglobulinemia in Castleman disease is particularly common, clinicians should be aware of this phenomenon when the laboratory findings do not fit the clinical picture. Although it is rare, recognition of potential paraprotein interference in immunoassays will help avoid undertreatment or overtreatment of patients based on erroneous laboratory results.

Dengue Haemorrhagic Fever and Dengue Shock Syndrome

2005 ◽  
pp. 245-245
Author(s):  
SC Sharma ◽  
Pushpa Yadav ◽  
Ratnesh Kanwar
Keyword(s):  
Dengue Shock Syndrome ◽  
Dengue Haemorrhagic Fever ◽  
Haemorrhagic Fever

An epidemic of dengue haemorrhagic fever/dengue shock syndrome in tropical India

1998 ◽  
Vol 18 (4) ◽  
pp. 289-293 ◽  
Author(s):  
V. Pushpa ◽  
M. Venkatadesikalu ◽  
Sheila Mohan ◽  
Thomas Cherian ◽  
T. Jacob John ◽  
...  
Keyword(s):  
Dengue Shock Syndrome ◽  
Dengue Haemorrhagic Fever ◽  
Haemorrhagic Fever

An epidemic of dengue haemorrhagic fever and dengue shock syndrome in Delhi: a clinical study

1990 ◽  
Vol 10 (4) ◽  
pp. 329-334 ◽  
Author(s):  
V. K. Srivastava ◽  
S. Suri ◽  
A. Bhasin ◽  
L. Srivastava ◽  
M. Bharadwaj
Keyword(s):  
Clinical Study ◽  
Dengue Shock Syndrome ◽  
Dengue Haemorrhagic Fever ◽  
Haemorrhagic Fever

scholarly journals Effect of Prior Symptomatic Dengue Infection on Dengue Haemorrhagic Fever (DHF) in Children

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Randula Ranawaka ◽  
Chamara Jayamanne ◽  
Kavinda Dayasiri ◽  
Dinuka Samaranayake ◽  
Udara Sandakelum ◽  
...  
Keyword(s):  
Dengue Fever ◽  
Past History ◽  
Secondary Infection ◽  
Severe Disease ◽  
Dengue Infection ◽  
Dengue Shock Syndrome ◽  
Dengue Haemorrhagic Fever ◽  
Severe Dengue ◽  
Haemorrhagic Fever ◽  
History Of

Pathogenesis of dengue haemorrhagic fever is not fully understood, but it is thought that there is antibody enhancement during the secondary infection, which causes severe dengue haemorrhagic fever (DHF). Therefore, patients who have DHF should have a documented history of symptomatic dengue infection in the past. A retrospective descriptive-analytical study was conducted at the University Paediatric Unit at Lady Ridgeway Hospital for Children, Colombo, Sri Lanka. All children who had fulfilled the criteria for DHF admitted to the unit from April 2018 to September 2018 were recruited into the study. Relevant data were collected from bed head tickets. One hundred and eighty-four children were included in the final analysis. Thirty-three (17.9%) had a past history of documented symptomatic dengue infection, while 82.1% did not have a documented dengue infection. Twelve patients had dengue shock syndrome, and none of them had previously documented symptomatic dengue fever. Dextran was used in 96 patients in the critical phase. Twelve (42%) patients with past documented symptomatic dengue fever needed dextran while 84 (54.9%) patients without a documented past history of dengue fever needed dextran. In our clinical observation, we noticed that children with DHF mostly did not have a documented symptomatic prior dengue infection, while those with a documented symptomatic prior infection had a milder subsequent illness. In fact, the majority (82.1%) of patients with DHF did not have documented previous symptomatic dengue infection. It was also observed that the clinical course of subsequent dengue infection was less severe in patients with previously documented symptomatic dengue fever. This finding should be further evaluated in a larger scale study minimizing the all-confounding factors. This fact is more important in selecting recipients for vaccines against the dengue virus, which are supposed to produce immunity against the virus without causing the severe disease.

scholarly journals Dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS) caused by serotype 2 in Brazil

1991 ◽  
Vol 86 (2) ◽  
pp. 269-269 ◽  
Author(s):  
Rita Maria R. Nogueira ◽  
Sonia M. O. Zagner ◽  
Ivan S. M. Martins ◽  
Elizabeth Lampe ◽  
Marize P. Miagostovich ◽  
...  
Keyword(s):  
Dengue Shock Syndrome ◽  
Dengue Haemorrhagic Fever ◽  
Haemorrhagic Fever

Human Urinary Soluble Thrombomodulin (MR-33) Improves Disseminated Intravascular Coagulation without Affecting Bleeding Time in Rats: Comparison with Low Molecular Weight Heparin

1997 ◽  
Vol 77 (04) ◽  
pp. 789-795 ◽  
Author(s):  
Yasuo Takahashi ◽  
Yoshitaka Hosaka ◽  
Kazunori Imada ◽  
Takehiro Adachi ◽  
Hiromi Niina ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Disseminated Intravascular Coagulation ◽  
Low Molecular Weight Heparin ◽  
Bleeding Time ◽  
Low Molecular Weight ◽  
Soluble Thrombomodulin ◽  
Intravascular Coagulation ◽  
Significant Prolongation ◽  
Dose Dependent Fashion ◽  
Dose Dependent

SummaryWe compared the antithrombotic and hemorrhagic effects of naturally existing human urinary soluble thrombomodulin (MR-33) with those of low molecular weight heparin (LMW-heparin) in rats. In in vitro experiments, MR-33 prolonged APTT in a dose-dependent fashion; its effect in this respect was as potent as that of LMW-heparin, but it was less potent than unfractionated heparin (UF-heparin). MR-33 was effective on endotoxin- or thromboplastin-induced disseminated intravascular coagulation (DIC) in rats. In both DIC models, infusion of MR-33 improved hematological abnormalities compatible with DIC in a dose-dependent fashion without excessive prolongation effect on APTT. Although LMW-heparin and UF-heparin also improved both DIC models, excessive prolongation of APTT was observed at high doses. It is well-known that the excessive prolongation of APTT with antithrombotic drugs like heparins is an index for hemorrhage, which is a major side effect in the treatment of DIC. We therefore further compared the antithrombotic (Benefit: dose required for 50% inhibition of fibrinogen decrease: ED50) and hemorrhagic (Risk: minimum dose required for significant prolongation of bleeding time) effects of MR-33 and LMW-heparin in the thromboplastin-induced DIC model. As a result, Benefit-Risk ratio was 1:27 for MR-33 and 1:3 for LMW heparin. These results indicate that MR-33 may be a clinically useful antithrombotic agent with reduced risk for hemorrhage compared with LMW-heparin.

Von Willebrand Disease (vWd) Characterized by Increased Ristocetin Aggregation: A Study of Eleven Cases

1975 ◽  
Author(s):  
N. Ciavarella ◽  
F. I. Pareti ◽  
Z. M. Ruggeri ◽  
P. M. Mannucci
Keyword(s):  
Factor Viii ◽  
Bleeding Time ◽  
Autosomal Dominant ◽  
Von Willebrand Disease ◽  
Bleeding Tendency ◽  
Laboratory Findings ◽  
Prolonged Bleeding Time ◽  
Von Willebrand ◽  
Willebrand Factor ◽  
Antihemophilic Factor

The defective ristocetin aggregation occurring in patients with vWd is thought to depend on the decrease of a plasmatic factor related to factor VIII (Willebrand factor, VIIIVWF) 10 patients from 3 families had a mild to moderate bleeding tendency with autosomal dominant pattern of inheritance and laboratory findings suggestive for vWd (decreased levels of antihemophilic factor, and factor- VIII related antigen reduced platelet retention to glass beads columns and prolonged bleeding time). However, ristocetin aggregation in PRP was markedly increased, although VIIIVWF plasma levels were decreased. Aggregation induced in PRP by other agents (such as ADP, adrenaline and collagen), and the release of 14C serotonin was normal; the addition of purified bovine factor VIII was followed by normal aggregation in patients’ PRP and washed platelets. Patients’ washed platelets added to normal plasma aggregated to ristocetin more than normal washed platelets with patients’ plasma; the most marked aggregation response, however, was obtained when patients’ washed platelets were mixed with their own plasma. These findings suggest that a, platelet component is involved in the hyperaggregation response to ristocetin of these patients; however, the interaction of platelets with patients’ plasma is needed to produce the maximum response.Supported by a grant of the Fondazione Angelo Bianchi Bonomi.

scholarly journals Aneurysm-related disseminated intravascular coagulation successfully treated by endovascular repair

2019 ◽  
Vol 11 (4) ◽  
Author(s):  
Miguel Lemos Gomes ◽  
Alice Lopes ◽  
Ana Parente Freixo ◽  
Gonçalo Sobrinho ◽  
Ruy Fernandes ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Disseminated Intravascular Coagulation ◽  
Endovascular Aneurysm Repair ◽  
Underlying Disease ◽  
Abdominal Aneurysm ◽  
Laboratory Findings ◽  
Intravascular Coagulation ◽  
Abdominal Aortic ◽  
Internal Iliac ◽  
Aneurysm Repair

Aortic abdominal aneurysm (AAA) is an uncommon etiology of disseminated intravascular coagulation (DIC). The authors report a case of an 81-year-old male patient who presented with hematuria, intraoral hemorrhage, melaenas and ecchymosis of the lower back and of the abdominal wall, after being medicated with etoricoxib for a back pain. During the study, an abdominal aortic aneurysm, which prolonged to the left common and internal iliac artery, was discovered. The diagnosis of AAA induced DIC was made. After endovascular aneurysm repair (EVAR), the patient’s hemorrhagic manifestations disappeared and the laboratory findings normalized. In conclusion, the state-of-the-art treatment of DIC is the elimination of the underlying disease; in this case, EVAR was proven to be effective in treating the aortic aneurysm and the AAA-related DIC.

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