Focal Renal Cortical Necrosis Associated With Zomepirac

Darwish, Riad; Vaziri, Nosratola D.; Gupta, Sudhir; Novey, Harold S.; Spear, Gerald S.; Licorish, Kenrick; Powers, David R.; Cesario, Thomas C.

doi:10.1016/s0022-5347(17)49088-4

Cited by 1 publication

(1 citation statement)

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“…We identified 26 articles, comprising 30 cases, reporting on the incidence of DIC in anaphylaxis published between 1980 and 2021 ( Table 1 ). 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 The underlying anaphylactic trigger was heterogeneous between cases with most reactions being due to insect stings ( n = 11), vascular graft material or tissue expanders (latex) ( n = 6), and antibiotic treatment ( n = 5). Only one case report (excluding this one) described anaphylaxis-induced DIC due to infusion of contrast media.…”

Section: Methods and Resultsmentioning

confidence: 99%

Disseminated Intravascular Coagulation in Anaphylaxis

Gelbenegger,

Buchtele,

Schoergenhofer

et al. 2023

Semin Thromb Hemost

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Anaphylaxis is a life-threatening condition that involves severe cutaneous, respiratory, and cardiovascular symptoms. Disseminated intravascular coagulation (DIC) is an acquired, widespread activation of coagulation that can be caused by infectious conditions (e.g., sepsis) and noninfectious conditions. The onset of DIC following anaphylaxis is not commonly known, and information regarding the pathomechanism linking anaphylaxis to DIC is scarce. Further, demographic and clinical data in anaphylaxis-induced DIC are still missing to this day. Triggered by a case of anaphylaxis-induced DIC that seamlessly transitioned to lethal sepsis-induced DIC, we aimed to characterize the patient population affected by anaphylaxis-induced DIC by performing a review of existing literature and expand the discussion to underlying mechanisms. The overall mortality of the patient cohort (n = 30) identified by the literature review was 50%. All patients that died either suffered a bleeding event or a thrombotic event. The majority of patients (n = 25/30; 83%) had bleeding events; thrombotic events were only reported in nonsurvivors (n = 9/15 or 60% of nonsurvivors; vs. n = 0/15 in survivors; p < 0.001). Nonsurvivors of anaphylaxis-induced DIC were on average 25 years older than survivors (p = 0.068). In conclusion, DIC can complicate anaphylaxis and is expected to contribute to poor microvascular perfusion after anaphylaxis. Particularly, elderly patients with known cardiovascular disease and patients who develop thrombotic events are susceptible to lethal outcomes. As a rare and largely uncharacterized disease entity, further research is needed to investigate the link between DIC and anaphylaxis and to potentially identify better treatment strategies.

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