1/18. Potentiation of warfarin's hypoprothrombinemic effect with miconazole vaginal suppositories.A 53-year-old woman being treated for a vaginal yeast infection experienced ecchymosis. Laboratory evaluation revealed a prolonged prothrombin time. It is possible that the bleeding was due to an interaction between warfarin and miconazole. health care professionals should be aware of the potential for drug interactions with vaginally administered miconazole, especially in women receiving anticoagulation therapy.- - - - - - - - - - ranking = 1keywords = coagulation (Clic here for more details about this article) |
2/18. Late onset of clinical symptoms and recurrent ecchymotic skin lesions in a 12-year-old girl with a severe double heterozygous protein c deficiency.The authors describe a 12-year-old girl with late-onset clinical symptoms due to severe protein c deficiency. Protein C gene analysis showed double heterozygosity for two distinct mutations, associated with type I protein c deficiency. Her parents and only brother were also evaluated. Coumarin-induced skin necrosis was a recurrent feature during oral anticoagulation therapy, forcing her physicians to treat her with nadroparin (Fraxiparin) for only a few months.- - - - - - - - - - ranking = 1keywords = coagulation (Clic here for more details about this article) |
3/18. Long-term management of chronic DIC associated with inoperable aortic aneurysm with low molecular weight heparin.Chronic DIC is a rare complication of aortic aneurysm. Surgical correction is the treatment of choice but for inoperable patients or those with continued DIC after surgery heparin can be used to control the coagulopathy. A case with inoperable multiple aortic aneurysm and chronic DIC managed successfully with dalteparin over a long period is discussed in this report.- - - - - - - - - - ranking = 1.8254454654534keywords = coagulopathy (Clic here for more details about this article) |
4/18. Acute promyelocytic leukemia: an unusual cause of fatal secondary postpartum hemorrhage.INTRODUCTION: Postpartum haemorrhage can rarely be associated with an underlying coagulation or haematological disorder. We wish to discuss a case of acute promyelocytic leukemia (APL) presenting as secondary postpartum hemorrhage (PPH), its clinical and pathological features and maternal outcome. CASE REPORT: We describe a 28-year-old woman who presented with secondary PPH accompanied by bleeding from gums, marked pallor, hematemesis, ecchymotic and purpuric spots all over the body, 8 days post-partum. Investigations revealed her to be having APL, a diagnosis not suspected by the referring clinic. She was given supportive therapy but died before chemotherapy could be started. CONCLUSION: The case emphasizes the importance of suspecting, investigating and energetically treating uncommon causes such as acute leukemia when an unusually severe clinical picture in a postpartum setting suggests such a possibility. This may prove to be life saving, particularly if the leukemia happens to be APL, a cancer with a very high cure rate.- - - - - - - - - - ranking = 1keywords = coagulation (Clic here for more details about this article) |
5/18. Coumarin necrosis--a review of the literature.skin and soft tissue necrosis is a rare complication of anticoagulation therapy. Two patients who exhibited the spectrum of this disorder are described. The clinical features, etiology, pathophysiology, and treatment of coumarin skin necrosis are outlined, and the English-language literature is reviewed.- - - - - - - - - - ranking = 1keywords = coagulation (Clic here for more details about this article) |
6/18. Ophthalmic complications with disseminated intravascular coagulation.Massive lid oedema, ecchymosis, proptosis with a total restriction of extraocular movement, markedly raised intraocular pressure, and occlusion of the central retinal artery developed acutely in the right eye of a 26-year-old woman with a past history of disseminated intravascular coagulation. She had been admitted to hospital for symptoms of abdominal pain and bleeding from multiple sites a few hours earlier. Five days previously she had some proptosis of the other eye and had been treated with antibiotics for suspected orbital cellulitis at another hospital. The oedema and proptosis resolved on high-dose intravenous corticosteroid therapy. Despite attempts to relieve the orbital oedema and raised intraocular pressure with a lateral canthotomy and antiglaucoma medications, the patient lost all perception of light in the right eye and has subsequently developed an optic nerve atrophy.- - - - - - - - - - ranking = 16.477864587658keywords = intravascular coagulation, coagulation, intravascular (Clic here for more details about this article) |
7/18. Autosensitization to dna.The spontaneous occurrence of widespread ecchymoses in a patient not exhibiting coagulopathy leads to a spectrum of differential diagnoses including amyloidosis, anaphylactoid purpura, pseudoxanthoma elasticum, ehlers-danlos syndrome, autoerythrocyte sensitization and autosensitization to dna (11). This paper reports on a patient exhibiting the characteristic clinical findings and skin reactivity indicative of dna autosensitization. The syndrome will be discussed briefly with particular reference to the differential diagnosis to autoerythrocyte sensitization.- - - - - - - - - - ranking = 1.8254454654534keywords = coagulopathy (Clic here for more details about this article) |
8/18. Bleeding disorders and non-accidental injury.Fifty children with suspected non-accidental injury, most of whom had bruising, were investigated to exclude a bleeding disorder. The following investigations were undertaken in each child: full blood count; platelet count, size, and shape; prothrombin time; partial thromboplastin time including mix with normal plasma; fibrinogen; and a bleeding time. The results of these initial investigations were abnormal in eight children (16%). One child had a severe coagulopathy secondary to spontaneously acquired inhibitory activity to coagulation factors which led to spontaneous bruising and noticeable signs of injury after a minor accident. The remaining children had several features supporting a diagnosis of non-accidental injury. Two had associated bleeding disorders in the form of von Willebrand's disease and a platelet aggregation abnormality and a baby had an acquired platelet disorder secondary to salicylates, provoking severe haemorrhage from a minor injury. The remaining four children initially had an abnormal laboratory finding--a prolonged partial thromboplastin time--which resulted in lengthy discussions during subsequent legal proceedings. Evidence of a bleeding disorder is not uncommon in non-accidental injury and the two conditions are not mutually exclusive.- - - - - - - - - - ranking = 2.8254454654534keywords = coagulopathy, coagulation (Clic here for more details about this article) |
9/18. Increased releasable vascular plasminogen activator and a bleeding diathesis.A 66-year-old man with metastatic prostatic carcinoma treated with high-dose (5 mg) diethylstilbestrol therapy underwent orchiectomy to allow discontinuation of estrogen. An extensive ecchymosis developed postoperatively in an area covered by elastic dressing tape; subsequently, it was learned that the patient had a recent history of frequent ecchymoses with mild trauma that proceeded to vesiculation. His alpha2-antiplasmin level was 132 percent, fibrin split products 4 micrograms/ml, and fibrinogen 293 mg/dl; routine coagulation results were normal. However, the level of releasable vascular plasminogen activator in a specimen drawn prior to surgery was 3.6 CTA units/ml, the highest value ever reported in this laboratory.- - - - - - - - - - ranking = 1keywords = coagulation (Clic here for more details about this article) |
10/18. Severe inherited "homozygous" protein c deficiency in a newborn infant.A relapsing clinical syndrome of skin lesions and disseminated intravascular coagulation (DIC) that showed remission with the infusion of fresh frozen plasma is described in a newborn infant with homozygous deficiency of protein C antigen. This patient presented since birth a recurrent clinical picture of DIC and ecchymotic skin lesions that resembled typical ecchymosis except for the fact that they showed immediate improvement with the administration of fresh frozen plasma. Using an enzyme linked immunosorbent assay method, the determination of protein C antigen levels in the patient, without ingestion of coumarin drugs, showed very low values (less than 1%). No other deficiencies in the vitamin-K-dependent factors or in antithrombin iii, antiplasmin, and plasminogen were found. Seven relatives of the infant had heterozygous deficiency in protein C antigen (values between 40-55%), without clinical history of venous thrombosis. The pedigree analysis of this family suggests an autosomal recessive pattern of inheritance for the clinical phenotype, although an autosomal dominant pattern has been postulated until now in other reported families. We conclude that our patient has a homozygous deficiency in protein C and this homozygous state may be compatible with survival beyond the neonatal period.- - - - - - - - - - ranking = 3.2955729175316keywords = intravascular coagulation, coagulation, intravascular (Clic here for more details about this article) |
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