scholarly journals Disseminated Intravascular Coagulation and Malignancy: A Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Sumit Sohal ◽  
Akhilesh Thakur ◽  
Aleena Zia ◽  
Mina Sous ◽  
Daniela Trelles
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Embolism ◽  
Cardiac Arrest ◽  
Disseminated Intravascular Coagulation ◽  
Limb Ischemia ◽  
Symptomatic Treatment ◽  
Malignant Cells ◽  
Intravascular Coagulation ◽  
Fluid Analysis ◽  
History Of

Disseminated Intravascular Coagulation (DIC) is a disorder of coagulation which is commonly seen as a complication of infections, traumas, obstetric diseases, and cancers especially hematological and rarely solid cancers. DIC may rarely be the presenting feature of an undiagnosed malignancy. It may present in the form of different phenotypes which makes its diagnosis difficult and leads to high mortality. The treatment comprises supportive, symptomatic treatment and removal of the underlying source. Here, we present a patient with history of being on warfarin for atrial fibrillation and other comorbidities who presented with elevated INR of 6.3 and increasing dyspnea on exertion. Over the course of her stay, her platelet counts started dropping with a concurrent decrease in fibrinogen levels. She eventually developed pulmonary embolism, followed by stroke and limb ischemia, which was indicative of the thrombotic phenotype of DIC. Her pleural fluid analysis showed huge burden of malignant cells in glandular pattern suggestive of adenocarcinoma and was started on heparin drip. However, the patient had cardiac arrest and expired on the same day of diagnosis.

Atrial fibrillation in acute pulmonary embolism: prognostic considerations

2013 ◽  
Vol 31 (4) ◽  
pp. 308-312 ◽  
Author(s):  
Sérgio Nuno Craveiro Barra ◽  
Luís Vilardouro Paiva ◽  
Rui Providência ◽  
Andreia Fernandes ◽  
António Leitão Marques
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Embolism ◽  
Previous History ◽  
Mortality Prediction ◽  
Prognostic Role ◽  
Prediction Ability ◽  
All Cause Mortality ◽  
Increase Risk ◽  
History Of ◽  
Acute Pe

AimsAlthough it is accepted that atrial fibrillation (AF) may be both the contributing factor and the consequence of pulmonary embolism (PE), data on the prognostic role of AF in patients with acute venous thromboembolism are scarce. Our aim was to study whether AF had a prognostic role in patients with acute PE.MethodsRetrospective cohort study involving 270 patients admitted for acute PE. Collected data: past medical history, analytic/gasometric parameters, admission ECG and echocardiogram, thoracic CT angiography. Patients followed for 6 months. An analysis was performed in order to clarify whether history of AF, irrespective of its timing, helps predict intrahospital, 1-month and 6-month all-cause mortality.ResultsPatients with history of AF, irrespective of its timing (n=57, 21.4%), had higher intrahospital (22.8% vs 13.1%, p=0.052, OR 2.07, 95% CI 0.98 to 4.35), 1-month (35.1% vs 16.9%, p=0.001, OR 3.16, 95% CI 1.61 to 6.21) and 6-month (45.6% vs 17.4%, p<0.001, OR 4.67, 95% CI 2.37 to 9.21) death rates. The prognostic power of AF was independent of age, NT-proBNP values, renal function and admission blood pressure and heart rate and additive to mortality prediction ability of simplified PESI (AF: p=0.021, OR 2.31, CI 95% 1.13 to 4.69; simplified PESI: p=0.002, OR 1.47, CI 95% 1.15 to 1.89). The presence of AF at admission added prognostic value to previous history of AF in terms of 1-month and 6-month all-cause mortality prediction, although it did not increase risk for intrahospital mortality.ConclusionsThe presence of AF, irrespective of its timing, may independently predict mortality in patients with acute PE. These data should be tested and validated in prospective studies using larger cohorts.

scholarly journals Disseminated intravascular coagulation in an under-recognised zoonotic infection

2017 ◽  
Vol 16 (3) ◽  
pp. 138-141
Author(s):  
Sarah Lawrence ◽  
◽  
Andrew Claxton ◽  
Mark Holland ◽  
Jack Hodd ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Disseminated Intravascular Coagulation ◽  
Platelet Transfusion ◽  
Purpura Fulminans ◽  
Blood Cultures ◽  
Organ Support ◽  
Zoonotic Infection ◽  
Intravascular Coagulation ◽  
Prompt Treatment ◽  
History Of

A 51 year old man presented with severe sepsis, disseminated intravascular coagulation (DIC) and multiorgan dysfunction after a 24 hour history of diarrhoea and malaise. Despite fluid resuscitation and receiving a platelet transfusion, freshfrozen plasma and intravenous broad-spectrum antibiotics, he remained anuric with a worsening metabolic acidosis. He was transferred to critical care for organ support including renal replacement therapy. He subsequently developed purpura fulminans. Blood cultures were positive for Captocytophaga carnimorsis, a gram-negative canine zoonosis that is an underdiagnosed cause of severe sepsis, for which DIC at presentation is characteristic. Treatment is with penicillins and fluoroquinolones. Identification of risk factors for unusual organisms and recognition of DIC allowing prompt treatment is critical for the acute physician.

scholarly journals Fatal case of acute fatty liver of pregnancy

2020 ◽  
Vol 10 (1) ◽  
pp. 410
Author(s):  
Sarada Mamilla ◽  
Sandhya Rani ◽  
Gayathri . ◽  
Bhavana . ◽  
Ramya Bharghavi ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Fatty Liver ◽  
High Mortality ◽  
Disseminated Intravascular Coagulation ◽  
Fatal Case ◽  
Mortality And Morbidity ◽  
Intravascular Coagulation ◽  
Acute Fatty Liver ◽  
In Pregnancy

Acute fatty liver in pregnancy is a catstrophic condition with high mortality and morbidity. Delay in managing complications would result in fatality. We present a case of 22-year-old primi, who presented to us in labor with jaundice and later developed, disseminated intravascular coagulation, Vulval haematoma, reexploration, sepsis, ARDS and cardiac arrest and death.

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