Female gender is protective, but ovariectomy attenuates the protective effect of female gender, in association with changes in renal expression of ET-1, VEGF, and eNOS. The accelerated disease in male rats can be attenuated by orchiectomy and consequent changes in expression of disease mediators.

Disseminated intravascular coagulation (DIC) may complicate hypovolemic shock secondary to trauma.1 Treatment with heparin in such cases is contraindicated because of the risk of bleeding at the site of trauma. Replacement therapy with clotting factors and platelets alone may be inadequate2 or result in volume overload in the presence of compromised renal function. We describe here a patient with multiple intraabdominal traumatic injuries whose severe bleeding diathesis secondary to DIC was successfully treated with exchange transfusion. CASE REPORT A 10-month-old black boy weighing 10 kg was brought to Children's Hospital of Michigan, Detroit with a history of grunting for three hours and "not feeling well" for three weeks.