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What Has Been Learned from Postmortem Studies?

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MR imaging findings in some rare neurological complications of paediatric cancer.

Neurological complications of paediatric cancers are a substantial problem. Complications can be primary from central nervous system (CNS) spread or secondary from indirect or remote effects of cancer, as well as cancer treatments such as chemotherapy and radiation therapy. In this review, we present the clinical and imaging findings of rare but important neurological complications in paediatric patients with cancer. Neurological complications are classified into three phases: pre-treatment, treatment and post-remission. Paraneoplastic neurological syndromes, hyperviscosity syndrome, haemophag

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… In 1977, Sack et al. reported that Trousseau’s syndrome is chronic disseminated intravascular coagulation (DIC) associated with non-bacterial thrombotic endocarditis and arterial thrombosis in patients with malignancy. …

Hematology and Immune-Related Disorders

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… When there are many fragments, the presence of turbulent blood flow or microangiopathic disorders such as hemangiosarcoma or disseminated intravascular coagulation (DIC) should be considered. …

Hematology

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… intravascular coagulation (DIC), thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome (HUS), HELLP syndrome, antiphospholipid antibody syndrome infections —HIV, EBV, CMV medications —heparin, GPIIb/IIIa inhibitors, quinine, quinidine, valproic acid, thiazides, sulfonamides, rifampin, … Causes include DIC, HELLP, TTP, HUS, malignancy, malignant hypertension, artificial heart valve, insertion of foreign bodies, and medications Disseminated Intravascular Coagulation (DIC) pathophysiology —damage to endothelium → release of tissue factor → massive activation of coagulation cascade → …

Сердечно-сосудистые заболевания

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Evaluation of transfusion pyrexia: a review of differential diagnosis and management.

Background/purpose. Transfusion pyrexia (fever) is an important clinical sign/symptom occurring either as an isolated event or as part of a constellation of signs and symptoms in relation to blood transfusion. It is an important cause of morbidity and may be an important sign of life-threatening complications of blood transfusion. Pyrexia is often a reason for the discontinuation of a blood transfusion episode, and adequate evaluation remains a challenge for clinicians. The decision to stop a blood transfusion episode on account of fever is often a difficult one. This paper reviews the differe

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… Uncontrollable bleeding due to disseminated intravascular coagulation may occur and may actually be the only sign of a haemolytic transfusion reaction in an unconscious or anesthetized patient. … Transfusion of heavily contaminated blood will usually lead to high fever, collapse, shock, and hemorrhagic phenomena due to disseminated intravascular coagulation (DIC). …

Association between platelet-white cell ratio and all-cause mortality in critically ill patients with atrial fibrillation: a retrospective cohort study.

BACKGROUND: Atrial fibrillation is common in intensive care units and portends poor prognosis. The platelet-to-white blood cell ratio is an emerging inflammatory-coagulatory biomarker with prognostic value in cardiovascular diseases. This study examines the association between platelet-white cell ratio (PWR) and all-cause mortality in this high-risk population. METHODS: In this retrospective cohort study, clinical data were obtained from the MIMIC-IV database. We included adult intensive care unit (ICU) patients with a diagnosis of atrial fibrillation. The PWR was evaluated as the primary expo

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… Diagnosis and management of sepsis-induced coagulopathy and disseminated intravascular coagulation. J Thromb Haemost JTH. 2019;17:1989–94. 10.1111/jth.14578. 21. Ko D-G, Park J-W, Kim J-H, Jung J-H, Kim H-S, Suk K-T, et al. … Disseminated intravascular coagulation in infectious disease. Semin Thromb Hemost. 2010;36:367–77. 10.1055/s-0030-1254046. 49. Lyu X, Xiong Y, Jiang L, Qin F. The independent predictive role of platelet to white blood cell ratio on all-cause mortality: a 7-year nationwide follow-up study in China. …

Mechanism and therapeutic potential of traditional Chinese medicine extracts in sepsis.

Sepsis is a complex syndrome characterized by multi-organ dysfunction, due to the presence of harmful microorganisms in blood which could cause mortality. Complications associated with sepsis involve multiple organ dysfunction. The pathogenesis of sepsis remains intricate, with limited treatment options and high mortality rates. Traditional Chinese medicine (TCM) has consistently demonstrated to have a potential on various disease management. Its complements include reduction of oxidative stress, inhibiting inflammatory pathways, regulating immune responses, and improving microcirculation. Tra

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… intravascular coagulation (DIC). … Others enhance patient survival rates by mitigating disseminated intravascular coagulation through anticoagulant activity. …

Clinical review: specific aspects of acute renal failure in cancer patients.

Acute renal failure (ARF) in cancer patients is a dreadful complication that causes substantial morbidity and mortality. Moreover, ARF may preclude optimal cancer treatment by requiring a decrease in chemotherapy dosage or by contraindicating potentially curative treatment. The pathways leading to ARF in cancer patients are common to the development of ARF in other conditions. However, ARF may also develop due to etiologies arising from cancer treatment, such as nephrotoxic chemotherapy agents or the disease itself, including post-renal obstruction, compression or infiltration, and metabolic o

A review on how to do hematology consults during COVID-19 pandemic.

The ongoing COVID-19 pandemic is the most trending and talked topic across the World. From its point of origin in Wuhan, China to clinical laboratory at NIH, a mere six-month-old SARS-CoV-2 virus is keeping the clinicians, and scientists busy at various fronts. However, COVID-19 is an emerging and evolving disease and each day brings in more data, new figures, and findings from the field of clinical practice. The role of hematologists has been increasingly recognized during the current pandemic because of several reasons. Most important of them are the characteristic hematological findings of

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… APTT: Activated partial thromboplastin time CAC: Coagulopathy associated with COVID-19, DIC: Disseminated intravascular coagulation, DOACs: FFP: Fresh frozen plasma, HIT: Heparin induced thrombocytopenia, LMWH: Low molecular weight heparin, PT: Prothrombin time, PCC: Prothrombin complex concentrate, … Coagulopathy in patients with COVID-19: Coagulopathy associated with COVID-19 (CAC) vs disseminated intravascular coagulation (DIC) In general, patients with impending multiorgan failure who develop disseminated intravascular coagulation (DIC) have the worst prognosis. …

Acquired platelet disorders.

Platelets are essential to primary hemostasis, and defects in their number or function can lead to clinically significant bleeding or thrombosis. Acquired platelet disorders are far more common than the inherited forms and arise in a wide range of settings, including drug exposure, autoimmune, systemic, and critical illnesses. This review examines current understanding of the mechanisms driving acquired platelet dysfunction and outlines the diagnostic and therapeutic approaches that are shaping contemporary standards of care. Drug-related and immune-mediated platelet defects remain the most re

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… Importantly, low platelet counts do not fully explain the bleeding risk in these disorders; qualitative platelet dysfunction and consumptive coagulopathies, including disseminated intravascular coagulation (DIC) also contribute substantially ( 60 ). … Disseminated intravascular coagulation in pediatric acute leukemia: prevalence, laboratory features, and prognostic significance of ISTH score. Int J Lab Hematol. (2025) 47:491–502. doi: 10.1111/ijlh.14425, PMID: 64. Goel G, Semwal S, Khare A, Joshi D, Amerneni CK, Pakhare A, et al. …

A Rapid Review of Adenocarcinoma and Pulmonary Tumor Thrombotic Microangiopathy: A Deadly Duo.

Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare paraneoplastic syndrome associated with various adenocarcinomas, most commonly gastric adenocarcinoma. This condition can progressively worsen pulmonary arterial hypertension, leading to acute or subacute pulmonary heart failure and respiratory insufficiency. This paper examines the pathogenesis, clinical presentation, diagnosis, treatment, and prognosis of PTTM. Given PTTM's poor prognosis, we emphasize treatment strategies. PTTM in adenocarcinoma patients can mimic other pulmonary diseases, causing diagnostic delays. Current PTTM tr

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… The interaction between the tumor emboli and endothelial cells via multiple mediators eventually results in the consumption of coagulation factors and platelets, consistent with commonly found laboratory findings, including thrombocytopenia, and disseminated intravascular coagulation (DIC) [ 25 ]. … Table 4 Summary of referred studies regarding the treatment and prognosis of PTTM DIC, disseminated intravascular coagulation; PAH, pulmonary arterial hypertension; PTTM, pulmonary tumor thrombotic microangiopathy Study author(s) | Type of study | Patient cancer type | Treatment | Outcome Lu et al. [ …

Platelet Transfusion for Patients with Cancer: An Update.

BackgroundPlatelet transfusion is essential for preventing and treating hemorrhage in oncology patients and can markedly improve quality of life and survival. However, access to platelet concentrates is often limited by global shortages and logistical constraints, especially in low-resource settings.SummaryMaintaining product quality requires stringent donor screening, pathogen-reduction technologies, and optimized storage conditions to preserve hemostatic function and reduce adverse reactions. Common transfusion-related complications (e.g., alloimmunization, non-hemolytic reactions, and circu

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… Tumor-associated disseminated intravascular coagulation (DIC) consumes platelets and clotting factors. Systemic activation of coagulation in DIC leads to microvascular thrombosis and potentially life-threatening hemorrhage attributed to the consumption of platelets and coagulation factors [ 39 ]. … Disseminated intravascular coagulation: epidemiology, biomarkers, and management. Br J Haematol. 2021;192(5):803–18. 40. Posado-Domínguez L, Chamorro AJ, Del Barco-Morillo E, Martín-Galache M, Bueno-Sacristán D, Fonseca-Sánchez E, et al. …

Challenges and Advances in Managing Thrombocytopenic Cancer Patients.

Cancer patients have varying incidence, depth and duration of thrombocytopenia. The mainstay of managing severe chemotherapy-induced thrombocytopenia (CIT) in cancer is the use of platelet transfusions. While prophylactic platelet transfusions reduce the bleeding rate, multiple unmet needs remain, such as high residual rates of bleeding, and anticancer treatment dose reductions/delays. Accordingly, the following promising results in other settings, antifibrinolytic drugs have been evaluated for prevention and treatment of bleeding in patients with hematological malignancies and solid tumors. I

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… This review focuses on CIT or cancer-related thrombocytopenia, outside the context of disseminated intravascular coagulation (DIC) [ 34 , 35 ]. 2.1.1. … Supportive management strategies for disseminated intravascular coagulation: An international consensus. Thromb. Haemost. 2016;115:896–904. doi: 10.1160/TH15-09-0740. 35. Levi M., Scully M. How I treat disseminated intravascular coagulation. …

Acute promyelocytic leukaemia in a Nigerian patient-a case report depicting challenges in the management of haematological malignancies in Nigeria.

IntroductionHaematological malignancies (HMs) account for approximately 10% of all malignancies in sub-Saharan Africa (SSA), and their incidence is rapidly increasing. Successful management of these malignancies depends on early presentation, diagnosis and prompt initiation of treatment. However, in SSA and many low and middle-income countries, several barriers hinder the effective management of these malignancies. This case report of a patient with acute promyelocytic anaemia highlights the challenges in managing HM.Case summaryA 31-year-old woman presented to a primary health care centre wit

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… List of abbreviations AML, Acute myeloid leukaemia; ANA, Anti-nuclear antibody; APL, Acute promyelocytic leukaemia; APTT, Activated partial prothrombin time; ATO, Arsenic trioxide; ATRA, All-trans-retinoic acid; CR, Complete remission; DIC, Disseminated intravascular coagulation; FBC, Full blood count …

Hematology

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… intravascular coagulation (DIC), thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome (HUS), HELLP syndrome, antiphospholipid antibody syndrome infections —HIV, EBV, CMV medications —heparin, GPIIb/IIIa inhibitors, quinine, quinidine, valproic acid, thiazides, sulfonamides, rifampin, … Causes include DIC, HELLP, TTP, HUS, malignancy, malignant hypertension, artificial heart valve, insertion of foreign bodies, and medications DISSEMINATED INTRAVASCULAR COAGULATION (DIC) pathophysiology —damage to endothelium → release of tissue factor → massive activation of coagulation cascade → …

Case report and review: Angiosarcoma with thrombocytopenia after total hip arthroplasty.

Total hip arthroplasty (THA) is a common treatment for osteoarthritis and is also performed for other conditions, such as secondary arthritis due to developmental dysplasia of the hip. Various THA types may be complicated by osteolysis and an inflammatory pseudotumor due to an adverse reaction to metal debris. Rarely, THA has been associated with malignant tumors, but their causality remains unclear. In this case report, we describe a female patient with developmental dysplasia of the hip. She had undergone left metal-on-polyethylene THA, acetabular revision of the THA, and left total knee art

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… AIHA, autoimmune hemolytic anemia; AS, angiosarcoma; CT, computed tomography; DIC, disseminated intravascular coagulation; DVT, deep vein thrombosis; GP, general practitioner; ITP, idiopathic thrombocytopenic purpura; IVIG, intravenous immunoglobulin; MARS-MRI, metal artifact–reducing sequence magnetic … Based on her laboratory results, autoimmune hemolytic anemia (AIHA), cold AIHA, idiopathic thrombocytopenic purpura (ITP), AIHA combined with ITP, and chronic disseminated intravascular coagulation (DIC) were considered possible. A cold hemagglutinin test was negative. …

Quality of Life as a Non-mortality Patient-centred Outcome in the Critically Ill: A Retrospective Analysis.

ObjectivesMortality is a common gauged endpoint in critically ill patients. Reduced quality of life is an aligned repercussion of protracted critical illness. Baseline status, severity of illness and its trajectory influence the outcomes. Patient-oriented outcomes are those that matter the most to a patient. However, quite often, family approves of trade-offs with survivorship in the Indian context. We looked at non-mortality outcomes in patients on high-intensity life-sustaining interventions admitted to the intensive care unit (ICU) despite poor prognosis and died on full support or survived

Targeting mast cells tryptase in tumor microenvironment: a potential antiangiogenetic strategy.

Angiogenesis is a complex process finely regulated by the balance between angiogenesis stimulators and inhibitors. As a result of proangiogenic factors overexpression, it plays a crucial role in cancer development. Although initially mast cells (MCs) role has been defined in hypersensitivity reactions and in immunity, it has been discovered that MCs have a crucial interplay on the regulatory function between inflammatory and tumor cells through the release of classical proangiogenic factors (e.g., vascular endothelial growth factor) and nonclassical proangiogenic mediators granule-associated (

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… Accordingly, GM has been therapeutically used for disseminated intravascular coagulation (DIC) and acute pancreatitis [ 95 ] in Japan, Italy, Korea, and Taiwan. … Nafamostat mesilate (FUT-175) in the treatment of patients with disseminated intravascular coagulation. Thrombosis and Haemostasis. 1989;62:p. 372. 134. Kimura T, Fuchimoto S, Iwagaki H, Hizuta A, Orita K. …

New insights into CAR T-cell hematological toxicities: manifestations, mechanisms, and effective management strategies.

Chimeric antigen receptor (CAR) T-cell therapy represents a highly efficacious treatment modality demonstrated to enhance outcomes in patients afflicted with malignancies, particularly those enduring relapsed or refractory hematological malignancies. However, the escalating adoption of CAR T-cell therapy has unveiled several life-threatening toxicities, notably cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), infections, and hematological toxicities (HTs), thereby hindering the broad implementation of CAR T-cell therapy. HTs encompass a spectrum

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… Notably, approximately 19.6% of patients afflicted with CARAC experience clinically significant bleeding, while 14–50% subsequently progress to develop disseminated intravascular coagulation (DIC), with mortality rates ranging from 6.7 to 42.9% among those diagnosed with DIC [ 126 ]. … Hemophagocytic lymphohistiocytosis and disseminated intravascular coagulation are underestimated, but fatal adverse events in chimeric antigen receptor T-cell therapy. Haematologica. 2023;108(8):2067–79. 61. Setiadi A, Zoref-Lorenz A, Lee CY, Jordan MB, Chen LYC. …