fibrin and Diarrhea

Topics: Acute Kidney Injury; Adolescent; Adult; Child; Child, Preschool; Diarrhea; Female; Fibrin; Humans; Hypocalcemia; Infant; Infant, Newborn; Kidney; Kidney Tubules; Male; Microscopy, Electron; Muscles; Muscular Diseases; Myofibrils; Myoglobinuria; Necrosis; Phosphorus; Respiratory Distress Syndrome, Newborn; Respiratory Tract Infections; Staining and Labeling; Tetany; Thrombosis

Topics: Aged; Biopsy; Chronic Disease; Colonic Polyps; Colonoscopy; Colorectal Neoplasms; Diagnosis, Differential; Diarrhea; Fibrin; Granulation Tissue; Humans; Hyperplasia; Inflammatory Bowel Diseases; Intestinal Mucosa; Male

Diarrhoea-associated haemolytic uraemic syndrome (D+ HUS) is usually caused by verotoxin producing Eschericia coli. We hypothesized that verotoxin binding to glomerular endothelial cells causes localised endothelial cell activation and thus activation of coagulation and reduction of fibrinolytic potential. We also proposed that treatment with fresh frozen plasma or dialysis would not affect these changes. Markers of activation of coagulation and fibrinolysis were measured in 30 children with acute D+ HUS serially, in healthy children and in children on dialysis. In acute D+ HUS, levels of thrombin-antithrombin III complex and prothrombin fragment 1+2 were significantly increased (p <0.001). The source of thrombin generation was unclear. Factor XIIa levels were increased in patients and controls with renal failure. Factor VIIa levels were not significantly raised in children with acute D+ HUS. D-dimers were increased, but fibrinolytic potential as measured by fibrin plate was reduced. Levels of plasminogen activator inhibitor antigen and activity and tissue plasminogen activator antigen were increased. Neither peritoneal dialysis nor administration of blood products, the most common treatments, altered parameters of coagulation or fibrinolysis.

Topics: Antithrombin III; Blood Coagulation; Blood Transfusion; Child; Diarrhea; Factor VIIa; Factor XIIa; Fibrin; Fibrin Fibrinogen Degradation Products; Fibrinogen; Fibrinolysis; Hemolytic-Uremic Syndrome; Humans; Peptide Fragments; Peritoneal Dialysis; Plasma Exchange; Plasminogen Activator Inhibitor 1; Prothrombin; Renal Dialysis; Thrombin; Tissue Plasminogen Activator

Diarrhea-associated hemolytic uremic syndrome (D+ HUS) is the most common cause of acute renal failure in children. The authors report their experience with D+ HUS with 114 patients assessed in Calgary from 1980 to 1992. Epidemiologic, clinical, and pathologic aspects are discussed.

Topics: Adolescent; Alberta; Child; Child, Preschool; Colitis, Ulcerative; Diarrhea; Feces; Female; Fibrin; Hemolytic-Uremic Syndrome; Humans; Incidence; Infant; Male; Thrombosis

Rectal biopsies from five patients with clindamycin-associated colitis were studied with the intention of identifying fibrin thrombi in capillaries. Capillary thrombosis was present in all five cases, three with pseudomembranous colitis and two with non-specific colitis. The significance of capillary thrombosis and its relationship to other ischaemic lesions of the gut are discussed.

Topics: Aged; Biopsy; Clindamycin; Colitis; Diarrhea; Female; Fibrin; Humans; Intestinal Mucosa; Male; Middle Aged; Rectum; Thrombosis