Meningococcal Disease pp 513-527 | Cite as
Coagulation Studies
- 600 Downloads
Abstract
Disseminated intravascular coagulation (DIC) is a complex acquired, coagulopathy resulting from excessive thrombin formation. Abnormal tissue factor (TF) expression is a major mechanism initiating DIC in many disorders, including obstetric complications, sepsis, cancer, and trauma. Numerous laboratory tests are available to monitor DIC, but most patients can be adequately managed using only routine hemostasis screening tests, and assays for fibrinogen and D-dimers. Treatment of DIC should focus on reversing the underlying disorder that initiated the coagulopathy. Novel treatments are being investigated for the treatment of DIC; many of these experimental modalities target the excessive TF activity that characterizes DIC.
Keywords
Disseminate Intravascular Coagulation Disseminate Intravascular Coagulation Coagulation System Meningococcal Disease Active Serine ProteinaseReferences
- 1.Wuillemin W. (1997) Activation of the contact system in patients with sepsis and with septic. Blood 89(10), 3893.PubMedGoogle Scholar
- 2.Pixley R., Cadena R. D. L., Page J., Kaufman N., Wyshock E., Chang A., Taylor F., and Colman R. (1993) The contact system contributes to hypotension but not disseminated intravascular coagulation in lethal bacteremia. J. Clin. Invest. 91, 61–68.CrossRefPubMedGoogle Scholar
- 3.Broze G. J., Jr. (1995) Tissue factor pathway inhibitor and the revised theory of coagulation. Annu. Rev. Med. 46, 103–112.CrossRefPubMedGoogle Scholar
- 4.Luchtman-Jones L. and Broze G. J. Jr. (1995) The current status of coagulation. Ann. Med. 27(1), 47–52.CrossRefPubMedGoogle Scholar
- 5.Muller-Berghaus G., ten Cate H., and Levi M. (1999) Disseminated intravascular coagulation: clinical spectrum and established as well as new diagnostic approaches. Thromb. Haemost. 82(2), 706–712.PubMedGoogle Scholar
- 6.Wada H., Wakita Y., Nakase T., Shimura M., Hiyoyama K., Nagaya S., Mori Y., and Shiku H. (1995) Outcome of disseminated intravascular coagulation in relation to the score when treatment was begun. Mie DIC Study Group. Thromb. Haemost. 74(3), 848–852.PubMedGoogle Scholar
- 7.Brandtzaeg P., Sandset P. M., Joo G. B., Ovstebo R., Abildgaard U., and Kierulf P. (1989) The quantitative association of plasma endotoxin, antithrom-bin, protein C, extrinsic pathway inhibitor and fibrinopeptide A in systemic men-ingococcal disease. Thromb. Res. 55(4), 459–470.CrossRefPubMedGoogle Scholar
- 8.Fourrier F., Lestavel P., Chopin C., Marey A., Goudemand J., Rime A., and Mangalaboyi J. (1990) Meningococcemia and purpura fulminans in adults: acute deficiencies of proteins C and S and early treatment with antithrombin III concentrates. Intensive Care Med. 16(2), 121–124.CrossRefPubMedGoogle Scholar
- 9.Fourrier F., Chopin C., Goudemand J., Hendrycx S., Caron C., Rime A., et al. (1992) Septic shock, multiple organ failure, and disseminated intravascular coagulation. Compared patterns of antithrombin III, protein C, and protein S deficiencies. Chest 101(3), 816–823.CrossRefPubMedGoogle Scholar
- 10.Fourrier F., Chopin C., Huart J., Runge I., Caron C., and Goudemand J. (1993) Double-blind, placebo-controlled trial of antithrombin III concentrates in septic shock with disseminated intravascular coagulation. Chest 104, 882–888.CrossRefPubMedGoogle Scholar
- 11.Leclerc F., Hazelzet J. A., Jude B., Hofhuis W., Hue V., Martinot A., and van der Voort E. (1992) Protein C and S deficiency in severe infectious purpura of children: a collaborative study of 40 cases. Intensive Care Med. 18(4), 202–205.CrossRefPubMedGoogle Scholar
- 12.Powars D. R., Rogers Z. R., Patch M. J., McGehee W. G., and Francis R. B. (1987) Purpura fulminans in meningococcemia: association with acquired deficiencies of protein C and S. N. Engl. J. Med. 317(9), 571–572.CrossRefPubMedGoogle Scholar
- 13.Powars D., Larsen R., Johnson J., Hulbert T. Sun T., Patch M. J., Francis R., and Chan L. (1993) Epidemic meningococcemia and purpura fulminans with induced protein C deficiency. Clin. Infect. Dis. 17, 254–261.PubMedGoogle Scholar
- 14.Fijnvandraat K., Derkx B., Peters M., Bijlmer R., Sturk A., Prins M. H., et al. (1995) Coagulation activation and tissue necrosis in meningococcal septic shock: severely reduced protein C levels predict a high mortality. Thromb. Haemost. 73, 15–20.PubMedGoogle Scholar
- 15.Hazelzet J. A., Risseeuw-Appel I. M., Kornelisse R. F., Hop W. C. G., Dekker I., Joosten K. F. M., de Groot R., and Hack C. E. (1996) Age-related differences in outcome and severity of DIC in children with septic shock and purpura. Thromb. Haemost. 76(6), 932–938.PubMedGoogle Scholar
- 16.Brandtzaeg P., Joo G. B., Brusletto B., and Kierulf P. (1990) Plasminogen activator inhibitor 1 and 2, alpha-2-antiplasmin, plasminogen, and endotoxin levels in systemic meningococcal disease. Thromb. Res. 57(2), 271–278.CrossRefPubMedGoogle Scholar
- 17.Kornelisse R. F., Hazelzet J. A., Savelkoul H. F. J., Hop W. C. J., Suur M. H., Borsboom A. N. J., Risseeuw-Appel I. M., v. d. Voort E., and d. Groot R. (1996) The relationship between plasminogen activator inhibitor-1 and proinflammatory and counterinflammatory mediators in children with meningococcal septic shock. J. Infect. Dis. 173, 1148–1156.PubMedGoogle Scholar
- 18.Voss R., Matthias R. R., Borkowski G., and Reitz D. (1990) Activation and inhibition of fibrinolysis in septic patients in an internal intensive care unit. Br. J. Haematol. 75, 99–105.CrossRefPubMedGoogle Scholar
- 19.Philippe I, Offner F., Declerck P. J., Leroux-Roels G., Vogelaers D., Baele G., and Collen D. (1991) Fibrinolysis and coagulation in patients with infectious disease and sepsis. Thromb. Haemost. 65(3), 291–295.PubMedGoogle Scholar
- 20.Hesselvik J. F., Blombäck M., Brodin B., and Maller R. (1989) Coagulation, fibrinolysis, and kallikrein systems in sepsis: relation to outcome. Crit. Care Med. 17(8), 724–733.CrossRefPubMedGoogle Scholar
- 21.Hermans P. W., Hibberd M. L., Booy R., Daramola O., Hazelzet J. A., de R. Groot, and Levin M. (1999) 4G/5G promoter polymorphism in the plasminogen-activator-inhibitor-1 gene and outcome of meningococcal disease. Meningococcal Research Group. Lancet 354(9178), 556–560.CrossRefPubMedGoogle Scholar
- 22.Taylor F. (1994) The inflammatory-coagulant axis in the host response to gram-negative sepsis: regulatory roles of proteins and inhibitors of tissue factor. N. Horizons 2, 555–565.Google Scholar
- 23.Esmon C. T., Fukudome K., Mather T., Bode W., Regan L. M., Stearns-Kurosawa D. J., and Kurosawa S. (1999) Inflammation, sepsis, and coagulation. Haematologica 84(3), 254–259.PubMedGoogle Scholar
- 24.Cicala C. and G. Cirino (1998) Linkage between inflammation and coagulation: an update on the molecular basis of the crosstalk. Life Sci. 62(20), 1817–1824.CrossRefPubMedGoogle Scholar
- 25.de Jonge E., Levi M., Stoutenbeek C. P., and van Deventer S. J. (1998) Current drug treatment strategies for disseminated intravascular coagulation. Drugs 55(6), 767–777.CrossRefPubMedGoogle Scholar
- 26.de Jonge E., Dekkers P. E., Creasey A. A., Hack C. E., Paulson S. K., Karim A., et al. (2000) Tissue factor pathway inhibitor dose-dependently inhibits coagulation activation without influencing the fibrinolytic and cytokine response during human endotoxemia. Blood 95(4), 1124–1129.PubMedGoogle Scholar
- 27.McManus M. L. and Churchwell K. B. (1993) Coagulopathy as a predictor of outcome in meningococcal sepsis and the systemic inflammatory response syndrome with purpura. Crit. Care Med. 21, 706–711.CrossRefPubMedGoogle Scholar
- 28.Vik-Mo H., Lote K., and Nordoy A. (1978) Disseminated intravascular coagulation in patients with meningococcal infection: laboratory diagnosis and prognostic factors. Scand. J. Infect. Dis. 10(3), 187–191.PubMedGoogle Scholar
- 29.Giraud T., Dhainaut J. F., Schremmer B., Regnier B., Desjars P., Loirat P., et al. (1991) Adult overwhelming meningococcal purpura. A study of 35 cases, 1977–1989. Arch. Intern. Med. 151(2), 310–31CrossRefPubMedGoogle Scholar
- 30.Leclerc F., Beuscart R., Guillois B., Diependaele J. F., Krim G., Devictor D., Bompard Y., and van-Albada T. (1985) Prognostic factors of severe infectious purpura in children. Intensive Care Med. 11(3), 140–143.CrossRefPubMedGoogle Scholar
- 31.Wuillemin W. A., Fijnvandraat K., Derkx B. H. F., Peters M., Vreede W., Cate H. T., and Hack C. (1995) Activation of the intrinsic pathway of coagulation in children with meningococcal septic shock. Thromb. Haemost. 74, 1436–1441.PubMedGoogle Scholar
- 32.Engebretsen L., Kierulf P., and Brandtzaeg P. (1986) Extreme plasminogen activator inhibitor and endotoxin values in patients with meningococcal disease. Thromb. Res. 42, 713–716.CrossRefPubMedGoogle Scholar
- 33.Fijnvandraat K., Peters M., Derkx B., van Deventer S., and ten Cate J. W. (1994) Endotoxin induced coagulation activation and protein C reduction in meningococcal septic shock. Prog. Clin. Biol. Res. 388, 247–254.PubMedGoogle Scholar
- 34.Blanco A., Guisasola J. A., Solis P., Bachiller R., and Gonzalez H. (1990) Fibronectin in meningococcal sepsis. Correlation with antithrombin III and protein C. Acta Paediatr. Scand. 79(1), 73–76.CrossRefPubMedGoogle Scholar