A Consumption Coagulopathy in an Infant with Hemolytic-Uremic Syndrome.

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  • 消耗性凝固障害症の像を呈した溶血性尿毒症症候群の1乳児例
  • ショウモウセイ ギョウコ ショウガイショウ ノ ゾウ オ テイシタ ヨウケツセイ ニョウドクショウ ショウコウグン ノ 1 ニュウジレイ

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Abstract

A report was made of a case of the hemolytic-uremic syndrome associated with consumption coagulopathy in a 2-month-old female infant.<br>After a week's duration of fever and diarrhea, the patient rapidly developed pallor, petechial hemorrhages and edema.<br>On admission, she was anemic with a slight jaundice. The liver was 6 cm and the spleen 4 cm palpable,<br>The hematologic examination showed RBC 3.46×106/mm3, Hb 8.8g/100ml, WBC 2,100/mm3. platelets 60,000/mm3 and reticulocytes 5‰. Peripheral blood smears levealed a marked anisocitosis, poikilocytosis and fragmented erythrocytes. Blood culture was negative, so was Coombs test. The direct serum bilirubin level was 0.9mg/100ml and indirect 1.4mg/100ml. The BUM level was 30mg/100ml. The albumin in urine was 2 plus. The bleeding time was over 30 minutes. Bleeding occurred from venipuncture sites and ear lobe.<br>A coagulation study revealed a marked prolonged clotting time, recalcification time, prothrombin time, kaolin partial thromboplastin time and thrombin time. The factor I level was 10mg/100ml. Levels of factors V and VIII were 36% and 28%, respectively. A moderate decrease was also found in factors II, VII, IX and X. No abnormal fibrinolysis was observed.<br>Despite a replacement thrapy of clotting factors and heparin adminstration, levels of factors I, II, VII, IX and X failed to increase on the fifth hospital day. The child died on the seventh hospital day. No autopsy was performed.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 15 (10), 1133-1141, 1974

    The Japanese Society of Hematology

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