Disseminated intravascular coagulation in hepatic failure treated with antithrombin III

Laursen, Birgitte Schantz; Mortensen, J.Z.; Frost, Lars; Hansen, Kjeld B.

doi:10.1016/0049-3848(81)90070-0

Cited by 49 publications

(15 citation statements)

References 6 publications

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“…Throm boembolic complications were noted in this patient. Preconativ is the least activated factor IX preparation of several investigated [12], Heparin was also given in order to potentiate the AT concentrate [2,17,25]. It is impor tant to control the anticoagulant activity of heparin carefully during the administration of AT concentrate.…”

Section: Discussionmentioning

confidence: 99%

“…The review of the current literature, mostly case reports, indicates a maternal mortality of about 30%, and a fetal mortality of about 50%. The diagnosis of AFLP was confirmed by liver biopsy in 77% of the cases reported in the period 1972-1981, and in the remaining 23% the clinical picture strongly indicated AFLP (table I) [3,6,8,11,13,14,16,17,19,20,22,26,27,[29][30][31],…”

Section: Review Of Literaturementioning

confidence: 99%

“…Very low AT levels can be noted during hepatic failure and DIC due to decreased synthesis and increased consumption [1,2]. A few reports concerning acute liver failure, DIC in pregnancy and treatment with AT concentrate have recently been published [17,25]. They report successful treatment with AT concentrate in combination with sub stitution of blood coagulation factors and platelets.…”

Section: Introductionmentioning

confidence: 99%

“…Early clinical signs are nausea and epigastric pain, symptoms easily interpreted as gastritis. As the disease progresses, many organs become involved and almost invariably gastrointestinal bleeding and se vere hypoglycemia occurs [5,9,10,15,21], This multiple organ failure can presumably be partly explained by concomitant disseminated intravascular coagulation (DIC) [8,14,16,17,20,31 ]. Thus, prompt treatment of occur ring DIC has been reported to reduce the high mortality rate related to acute hepatic failure [23].…”

Section: Introductionmentioning

confidence: 99%

“…The present paper reports on another case of acute hepatic and renal insufficiency, DIC and intrauterine fetal death with successful treatment of the mother. Further more the recent literature is reviewed [3,6,8,11,13,14,16,17,19,20,22,26,27,[29][30][31],…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Severe Acquired Antithrombin III Deficiency in Relation to Hepatic and Renal Insufficiency and Intrauterine Fetal Death in Late Pregnancy

Hellgren¹,

Hägnevik²,

Robbe³

et al. 1983

Gynecol Obstet Invest

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Acute fatty liver (AFLP) is a rare complication of late pregnancy. The maternal and fetal mortality has earlier been reported to be about 75 %, but during the last decade a reduced mortality to about 30 and 50%, respectively, has been reported in the literature. Disseminated intravascular coagulation (DIC) has been suggested as a contributing cause to the high mortality. The treatment of DIC has long been under debate, and recently the administration of antithrombin III (AT) concentrate in addition ot other supportive treatment has been reported successful. This paper presents the survival of 1 patient with severe liver and renal failure indicating AFLP complicated by severe disturbances in blood coagulation and fibrinolysis. The patient was treated with AT concentrate and small doses of heparin, blood coagulation factors, large amounts of glucose intravenously and supportive intensive care. The pregnancy was terminated by cesarean section. The child was stillborn and 75% of the placental parenchyma was fibrosed.

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