Screening tests of disseminated intravascular coagulation: Guidelines for rapid and specific laboratory diagnosis

Yu, Mengna; Nardella, A; Pechet, Liberto

doi:10.1097/00003246-200006000-00013

Cited by 76 publications

(62 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…tsutsugamushi frequently invades the central nervous system (CNS); indeed the word "typhus" is derived from the term "typhos" meaning "stupor." The CNS is affected in 20-33% of patients infected by the Rickettsia that causes Rocky Mountain spotted fever, 1,11 and in a minority of cases of epidemic typhus or scrub typhus (2-5%). 10 Pai and others 12 identified O. tsutsugamushi DNA using nested PCR in the CSF in 6 of 25 patients with scrub typhus.…”

Section: Discussionmentioning

confidence: 99%

Scrub Typhus Meningitis or Meningoencephalitis

Kim

Chung²,

Yun³

et al. 2013

The American Society of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. Orientia tsutsugamushi induces vasculitis leading to symptoms of systemic organ invasion including meningitis and meningoencephalitis. We conducted a retrospective case-control study of scrub typhus patients to investigate the clinical and laboratory features of patients with scrub typhus meningitis or meningoencephalitis, and the therapeutic outcomes, and to determine the predictor factors. Cases were 22 patients with scrub typhus meningitis or meningoencephalitis, and controls were 303 patients without meningitis or meningoencephalitis. Multivariate analysis showed that the presence of pneumonitis was associated with the occurrence of scrub typhus meningitis and meningoencephalitis (odds ratio [OR] 8.9; P 0.001; confidence interval [CI] 2.9-27.2). Although appropriate antimicrobials such as doxycycline agents were administered at an early stage, meningitis or meningoencephalitis still occurred in some cases. Physicians should be aware that meningitis or meningoencephalitis may develop during appropriate drug therapy such as doxycycline. Close observation and great care are essential for patients with risk factors, particularly pneumonitis.

show abstract

Section: Discussionmentioning

confidence: 99%

Scrub Typhus Meningitis or Meningoencephalitis

Kim

Chung²,

Yun³

et al. 2013

The American Society of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

show abstract

“…Our findings suggest that the diagnostic criteria for overt DIC or DIC may be improved by changing the cut-off values in the global coagulation tests. D-dimer and FDP were reported to provide a rapid and specific diagnosis of DIC [23]. We previously examined the pre-DIC state using molecular hemostatic markers such as D-dimer and thrombinantithrombin complex [24].…”

Section: Discussionmentioning

confidence: 99%

Comparison of diagnostic criteria for disseminated intravascular coagulation (DIC): diagnostic criteria of the International Society of Thrombosis and Hemostasis (ISTH) and of the Japanese Ministry of Health and Welfare for overt DIC

et al. 2003

View full text Add to dashboard Cite

We compared the criteria set by the International Society of Thrombosis and Hemostasis (ISTH) for the diagnosis of disseminated intravascular coagulation (DIC) with the criteria of the Japanese Ministry of Health and Welfare (JMHW) set for the diagnosis of overt DIC. We studied 1,284 Japanese patients with DIC. The rate of agreement in the diagnosis of DIC by the two diagnostic systems was 67.4%. In addition, only 2.0% of non-DIC patients by JMHW criteria were diagnosed with overt DIC by ISTH criteria, suggesting that ISTH for overt DIC includes typical cases of DIC. The concordance of diagnosis for DIC by ISTH and JMHW was significantly high in patients with trauma or acute promyelocytic leukemia. About 70% of DIC or overt DIC patients had more than 1 point in the scoring system for prothrombin time, but >50% of those patients had 0 point for plasma fibrinogen level. Abnormal fibrin and fibrinogen degradation product (FDP) levels and platelet counts were observed in >88% of DIC and overt DIC patients but were observed in >50% of non-DIC patients, indicating that these parameters are sensitive markers but not specific markers for the diagnosis of DIC. Considered together, our results suggest that the diagnostic criteria for DIC and overt DIC could be improved by changing the cut-off values of the global coagulation tests. Am. J. Hematol. 74:17-22, 2003.

show abstract

“…Diagnosis of DIC is complex because of the lack of specific tests (5). Routine coagulation analysis such as prothrombin time (PT) and activated partial thromboplastin time (aPTT) are available in most laboratories but have a low specificity and sensitivity for diagnosing DIC (6). Furthermore, increased activation of the procoagulant pathway and activation or inhibition of the fibrinolytic system cannot be portrayed accurately by these standard assays (7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Thromboelastometry (TEM®) Findings in Disseminated Intravascular Coagulation in a Pig Model of Endotoxinemia

Schöchl

Solomon²,

Schulz

et al. 2010

Mol Med

View full text Add to dashboard Cite

Standard coagulation tests have a low specificity and sensitivity for diagnosing disseminated intravascular coagulation. The aim of this study was to determine whether whole blood thromboelastometry (TEM) detects lipopolysaccharide (LPS)-induced changes in coagulation. Blood samples from 10 pigs were drawn at baseline, before and at the end of LPS infusion and 2, 3, 4 and 5 h after the start of endotoxinemia. Simultaneous to TEM, standard coagulation tests and extended coagulation analysis including tissue plasminogen activator (t-PA) and plasminogen activator inhibitor 1 (PAI-1) were performed. Endotoxinemia resulted in a significant acceleration of the nonactivated TEM (NATEM) clotting time 2 h after the end of LPS infusion; in contrast, the changes in international normalized ratio and activated partial thromboplastin time suggested delayed initiation of coagulation. NATEM maximum clot firmness (MCF) and fibrin-based thromboelastometry test (FIBTEM ® )-MCF decreased significantly from baseline until the last time point (from 64.6 ± 7.8 and 35.1 ± 12.8 mm to 52.8 ± 4.6 and 21.4 ± 11.8 mm, respectively; P = 0.01 for both parameters). A sharp, transient increase of t-PA had no effect on maximum lysis in the NATEM test. PAI-1 increased significantly 3 h after the start of LPS infusion, paralleled by a decrease in maximum lysis. In conclusion, TEM was superior to standard coagulation tests in reflecting initial activation of coagulation during endotoxinemia. TEM further suggested consumption of coagulation substrate; at the same time, inhibition of plasminogen activation was accompanied by improved clot stability. Further investigations are necessary to establish the clinical relevance of these findings.

show abstract

Screening tests of disseminated intravascular coagulation: Guidelines for rapid and specific laboratory diagnosis

Cited by 76 publications

References 11 publications

Scrub Typhus Meningitis or Meningoencephalitis

Scrub Typhus Meningitis or Meningoencephalitis

Comparison of diagnostic criteria for disseminated intravascular coagulation (DIC): diagnostic criteria of the International Society of Thrombosis and Hemostasis (ISTH) and of the Japanese Ministry of Health and Welfare for overt DIC

Thromboelastometry (TEM®) Findings in Disseminated Intravascular Coagulation in a Pig Model of Endotoxinemia

Contact Info

Product

Resources

About