:Its relation to serum trypsin level and pathological findings
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概要
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Pancreatic involvement in DIC is not fully documented. So a retrospective study was done to clarify it. Four cases (13%) out of 30 autopsy cases, clinically diagnosed as DIC in our laboratory for previous 9 years, showed the pathological evidence of pancreatic involvement.Serum amylase and trypsin levels of which increase is known to indicate the development of pancreatic lesions were measured in 22 cases of DIC for recent 3 years using neo-amylase test (Daiichi) and trypsin radio-immunoassay ki t (Cis-Sorin) respectively. Mean values of amylase and trypsin were 321.1±377.6 Somogi u/dl and 73.1±53.1ng/ml respectively and both increased as compared to normal controls. Furthermore correlation between trypsin levels and biochemical data or hemostatic data were studied. Only BUN and creatinine showed positive correlation with trypsin levels.A 29 year-old female at 23 weeks' gestation was presented. DIC had occurred immediately after artificial abortion with the symptomes of genital bleeding, G-I bleeding and oliguria. Coagulation study revealed high level of FDP, positive SFMC and decreased platelet counts and fibrinogen level. Despite of intensive cares, heparin treatment and peritoneal dialysis no sign of improvement was obtained and the patient died on the 32th postoperative day. Postmortem examination showed stomach cancer with multiple metastasis of mild degree and pancreatic infarction, besides multiple fibrin thrombi in lungs and kidneys. Retrospective analysis revealed marked increase of serum trypsin level which would show the occurrence of pancreatic involvement since the onset of DIC and might be concerned with the deteriolation of DIC.High levels of serum trypsin in DIC are related to renal function, but sometimes its marked increase showed the presence of pancreatic involvement which may lead to one of the aggravatig factors of DIC.
- 一般社団法人 日本血栓止血学会の論文
一般社団法人 日本血栓止血学会 | 論文
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