Intravascular Coagulation in an Infant with the Hemolytic‐Uremic Syndrome

Serum levels of fibrin-fibrinogen degradation products in the haemolytic-uraemic syndrome.

“…The syndrome has many similarities to the Shwartzman phenomenon, and theoretically treatment with heparin should prevent the occurrence of further intravascular coagulation by means of its antithromboplastin and antithrombin activity, while allowing the fibrinolytic enzymes to degrade fibrin already deposited. Fibrin degradation products have already been shown non-quantitatively in this syndrome by Monnens and Schretlen (1967) and quantitated at a level of 140 ,zg./ml. in one of the cases of Brain et al (1968), later rising to about 300 ,tg./ml.…”

The Fibrinolytic System in the Hemolytic Uremic Syndrome: In Vivo and In Vitro Studies

“…Even if inflammatory mediators contribute locally to the increase of the t-PA, PAI-1, and vWF levels in plasma, it is likely that other factors that are generated in the injured intestines or kidneys are an important cause of the sustained elevation of the t-PA, PAI-1, and vWF concentrations in the blood of HUS patients (3840). Activated leukocytes, which can be found in the peripheral blood in HUS (41), contribute to endothelial activation, and other factors such as activated complement and coagulation factors may be involved (42)(43)(44)(45). In our patients, no release of t-PA, u-PA, and vWF could be evoked by DDAVP infusion on admission.…”

Hemolytic-Uremic Syndrome

“…A number of investigators have suggested that a process of disseminated intravascular coagulation (DIC) plays a role in the development of the endothelial lesion [70][71][72][73][74]. It has been demonstrated that the thrombi found in the glomerular capillaries in the experimental model are com posed of fibrin and its by-products by histochemical [75], by electron microscopic [76] and by immunofluorescent techniques [77], At the time of maximal fibrin deposition, hypofibrinogenemia and thrombocytopenia develop [78] and platelet material can be found with electron microscopy in the thrombi [78].…”