1/12. Multicentric warfarin-induced skin necrosis complicating heparin-induced thrombocytopenia.Two patients developed catastrophic multicentric skin necrosis while receiving warfarin to treat venous thromboembolism complicated by immune-mediated heparin-induced thrombocytopenia (HIT). Patient 1 developed skin necrosis involving the breasts, thighs, and face, as well as venous limb gangrene and bilateral hemorrhagic necrosis of the adrenal glands, resulting in death. The second patient developed bilateral mammary necrosis necessitating mastectomies, as well as skin necrosis involving the thigh. Neither patient had an identifiable hypercoagulable syndrome, other than HIT. HIT may represent a risk factor for the development of multicentric warfarin-induced skin necrosis (WISN).- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
2/12. pulmonary embolism presenting as disseminated intravascular coagulation.We report an unusual case of disseminated intravascular coagulation. Occult pulmonary embolism is a recognised cause of disseminated intravascular coagulation. Unexplained shock should prompt the physician to search for a thrombotic cause such as pulmonary thromboembolism.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
3/12. amniotic fluid embolism with involvement of the brain, lungs, adrenal glands, and heart.The case of a healthy 31-year-old woman in the 40th week of second pregnancy is presented. During preparation for an emergency caesarean section, she developed an amniotic fluid embolism (AFE) with unusual and unique features. The acute onset of disease with cardiorespiratory failure with hypotension, tachycardia, cyanosis, respiratory disturbances and loss of consciousness, suggested at first a pulmonary thromboembolism, but the appearance of convulsions led to the diagnosis of AFE. The patient died after 5 days due to an untreatable brain edema. At autopsy, AFE with the usually associated disseminated intravascular coagulation was found in the lungs, brain, left adrenal gland, kidneys, liver and heart. Eosinophilic inflammatory infiltrates were found in the lungs, hepatic portal fields and especially in the heart, suggesting a specific hypersensitivity reaction to fetal antigens. Moreover, intravascular accumulation of macrophages in the lungs also favored a non-specific immune reaction to amniotic fluid constituents.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
4/12. Adrenal cortical carcinoma initially presented with overwhelming disseminated intravascular coagulation.We report a 54-year-old man who had adrenal cortical carcinoma initially manifested as features of overwhelming disseminated intravascular coagulation (DIC). In the initial diagnostic work-up, an adrenal mass was detected with venous thrombi in the abdominal imaging study, but the radiologic diagnosis was a hematoma arising from the adrenal gland and a biopsy was not possible due to a bleeding tendency. A lot of platelets and plasma products were transfused, but the bleeding tendency and other DIC features persisted. Finally, he expired because of newly developed massive pulmonary thromboembolism. To our knowledge, this is the first reported case of adrenal cortical carcinoma complicated with bleeding tendency caused by DIC as an initial manifestation. This suggests that adrenal cortical carcinoma should be considered in a patient with an adrenal mass and DIC features.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
5/12. Disseminated microvascular pulmonary tumor cell embolism: a rare cause of fulminant pulmonary hypertension.BACKGROUND: Disseminated pulmonary tumor embolization is a rare cause of pulmonary hypertension and is often diagnosed only after the patient has died. CASE REPORT: We report on a 41-year-old male who was admitted because of severe dyspnea and tachycardia. Contrast enhanced spiral computed tomography did neither establish pulmonary thromboembolism nor pulmonary metastasis. Right heart catheterization revealed severe pulmonary hypertension (pulmonary vascular resistance (PVR) 678 dyn x sec x cm(-5)). PVR did not respond to therapy with intravenous nitrate or inhaled iloprost in this critically ill patient. 2 days after admission, the patient died because of refractory right heart failure. autopsy revealed microscopic pulmonary tumor embolism due to a metastasizing adenocarcinoma of the pancreas. CONCLUSION: Disseminated tumor cell embolism should be considered as a rare differential diagnosis in patients with refractory pulmonary hypertension.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
6/12. Successful treatment of acute right cardiac failure due to pulmonary thromboembolism in mixed connective tissue disease.mixed connective tissue disease (MCTD) is characterized as a benign rheumatic disease with a favorable response to therapy. When pulmonary hypertension is a complication, however, it is often reported to be fatal. A 32-year-old female patient with MCTD who had developed rapidly progressive pulmonary hypertension and disseminated intravascular coagulopathy was admitted to our hospital and was successfully treated with corticosteroids and anticoagulants. The failure of microcirculation due to coagulopathy is considered to be one of the possible entities of pulmonary hypertension.- - - - - - - - - - ranking = 4keywords = thromboembolism (Clic here for more details about this article) |
7/12. Recurrent thromboembolism, disseminated intravascular coagulation, and coumarin-induced skin necrosis associated with protein c deficiency.Defiency of protein C has been reported to be associated with recurrent thrombosis and pulmonary embolism, disseminated intravascular coagulation, and coumarin-induced skin necrosis and peripheral gangrene. That all of these serious and eventually lethal complications of protein c deficiency, including embolic myocardial infarction, may occur in the same person is the subject of this case report and description of pathological findings.- - - - - - - - - - ranking = 4keywords = thromboembolism (Clic here for more details about this article) |
8/12. cerebral infarction from non-bacterial thrombotic endocarditis. Clinical and pathological study including the effects of anticoagulation.The clinical and pathologic findings in 42 autopsy proved cases of cerebral infarction from cancer-associated non-bacterial thrombotic endocarditis were reviewed. Carcinoma of the lung was the most common malignancy. Most patients had disseminated cancer, but in six patients, the condition was stable or in remission, and six patients had localized cancer; two patients were not known to have cancer until neurologic symptoms developed. Neurologic symptoms were focal, suggesting stroke in 18; diffuse, suggesting metabolic encephalopathy in nine; and mixed in five. Neurologic signs were often the only evidence of thromboembolism. The definitive diagnostic test was cerebral angiography showing multiple arterial occlusions. Anticoagulation with heparin appeared to help some patients and did not promote brain hemorrhage. early diagnosis and vigorous treatment of non-bacterial endocarditis may prevent severe neurologic disability.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
9/12. heparin-induced thrombocytopenia and recurrent thrombosis in pregnancy. A case report.heparin-induced thrombocytopenia with thromboembolism calls for an immediate substitution of the heparin with other potent anticoagulants, such as coumarin derivatives. The occurrence of this adverse effect in pregnancy poses an additional dilemma because the use of coumarin derivatives is not acceptable during pregnancy, while other medications may not be as effective. In a pregnant patient treated with mucous sodium heparin for deep vein thrombosis, recurrent heparin-induced thrombosis and disseminated intravascular coagulation (DIC) occurred. Replacing the heparin with a different brand of the same drug resulted in reversal of the DIC and in clinical improvement. If severe heparin-induced thrombosis occurs in a patient in whom anticoagulation with other drugs is contraindicated, substituting one brand of heparin for another could be of value.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
10/12. White clot syndrome associated with renal failure.In a minority of patients, heparin administration is associated with thrombocytopenia and this thrombocytopenia may be associated with thromboembolic events. heparin-associated thromboembolism is described as heparin-associated thrombocytopenia and thrombosis or white clot syndrome. White clot syndrome is caused by antibodies to a heparin-platelet membrane complex. The diagnosis carries a high mortality and morbidity from limb thromboembolism. Treatment includes discontinuation of heparin, use of alternate anticoagulants, and aggressive treatment of thromboses. A case in which acute renal failure occurred in the setting of heparin treatment and thrombocytopenia is described, and evidence that renal failure was a result of white clot syndrome is provided.- - - - - - - - - - ranking = 2keywords = thromboembolism (Clic here for more details about this article) |
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