Disseminated intravascular coagulation diagnosis

Diagnosis and treatment of disseminated intravascular coagulation, a severe hemorrhagic disorder. 

Dantrolene should be repeated after 5—8 hr. Bicarbonate, procaine amide, and other drugs should be repeated as needed. Treatment of disseminated intravascular coagulation is symptomatic. Early diagnosis and treatment ofMH is essential. After effective treatment, the patient should be watched closely in the intensive care unit for recurrence of MH, myoglobinuric renal failure, disseminated intravascular coagulation, muscle weakness, and electrolyte imbalance. 

Identify which laboratory tests may aid in the diagnosis of disseminated intravascular coagulation (DIC). 

Francini M. Pathophysiology, diagnosis and treatment of disseminated intravascular coagulation An update. Clin Lab 2005 51(11—12) 633—639. 

Suggested Alternatives for Differential Diagnosis Scarlet fever, cellulitis, cat scratch disease, gas gangrene, necrotizing fasciitis, tick-borne diseases such as Rocky Mountain spotted fever, pneumonia, septic shock, acute respiratory distress syndrome (ARDS), disseminated intravascular coagulation. 

Suggested Alternatives for Differential Diagnosis Malaria, typhoid fever, shigellosis, meningococcemia, salmonella infection, other tick-borne diseases, rickettsial infections, leukemia, lupus, disseminated intravascular coagulation, hemolytic uremic syndrome, leptospirosis, thrombocytopenic purpura, and idiopathic or thrombotic thrombocytopenic purpura. 

Suggested Alternatives for Differential Diagnosis Acute poststreptococcal glomerulonephritis, spotted fevers, typhus, malaria, hepatitis, Colorado tick fever, septicemia, heat stroke, disseminated intravascular coagulation, leptospirosis, hemolytic uremic syndrome. 

A 19-year-old man consumed ecstasy for the entire duration of a discotheque party (lasting until morning) and had respiratory difficulty, uncoordinated movements, generalized hypertonia, and hyperpyrexia (40.6°C). The diagnosis was disseminated intravascular coagulation and was treated with heparin but suffered severe blood loss from the oral cavity and injection wounds. He subsequently had a cardiac arrest. 

Thrombotic thrombocytopenic purpura is a rare acute or subacute disease in adults, rather similar to the hemolytic uremic syndrome in children, in which there is systemic malaise, fever, skin purpura, renal failure, hematuria and proteinuria. Hemorrhagic infarcts caused by platelet microthrombi occur in many organs in the brain they may cause stroke-like episodes (Matijevic and Wu 2006) although more commonly there is global encephalopathy. The blood film shows thrombocytopenia, hemolytic anemia and fragmented red cells. The differential diagnosis includes infective endocarditis, idiopathic thrombocytopenia, heparin-induced thrombocytopenia with thrombosis, systemic lupus erythematosus, non-bacterial thrombotic endocarditis and disseminated intravascular coagulation. 

The differential diagnosis includes a number of viral and bacterial diseases, including influenza, meningo-coccemia. Rocky Mountain spotted fever, malaria, and others, as well as noninfectious causes such as idiopathic and thrombotic thrombocytopenic purpuras, hemolytic uremic syndrome, and DlC (disseminated intravascular coagulation). 

Generalized muscle rigidity (found in 70% of the patients involved) and a progressive rise in body temperature (sometimes beyond 43°C) are the main clinical features, often associated with tachycardia, hypoxia, metabolic acidosis, cardiac dysrhythmias and, less often, disseminated intravascular coagulation, cerebral edema, and acute renal insufficiency. Diagnosis relies on the clinical signs, that is muscle rigidity and hyperpyrexia, and on raised serum activities of skeletal and cardiac muscle enzymes, for example aldolase and creatine kinase. 

Bick RL. Disseminated intravascular coagulation Current concepts of etiology, pathophysiology, diagnosis, and treatment. Hematol Oncol Clin North Am 2003 17 149-176. 

Cardiovascular A 17-year-old man with a 3-year history of ulcer symptoms, diarrhea, and bouts of abdominal colic developed severe hypotension (50/20 mmHg) after receiving intravenous metoclopramide for acute vomiting with diarrhea [9 ]. He then developed pneumonia, rhabdomyolysis, renal tubular necrosis, and disseminated intravascular coagulation. A diagnosis of gastrinoma was made. During hormonal assessment, he received a second dose of... 

---