{"title":"[Newly diagnosed non-acute promyelocytic leukemia combined with disseminated intravascular coagulation: a case report and literature review].","authors":"M Zhou, J Chen, Y Han","doi":"10.3760/cma.j.cn121090-20241129-00499","DOIUrl":"10.3760/cma.j.cn121090-20241129-00499","url":null,"abstract":"<p><p><b>Objective:</b> Disseminated intravascular coagulation (DIC) is common in newly diagnosed acute promyelocytic leukemia (APL), with a high mortality rate. This case report focuses on a successful treatment of non-APL complicated with DIC, aiming to enhance clinical physicians' awareness and diagnostic skills in managing non-APL complicated by DIC. <b>Methods:</b> The diagnosis and treatment of a non-APL patient with DIC was detailed and related literature was reviewed. <b>Results:</b> With the help of early identification of DIC, chemotherapy and supportive treatment, the patient successfully recovered from DIC and achieved complete remission after induction therapy. He achieved long-term survival via subsequent hematopoietic stem cell transplantation. <b>Conclusion:</b> Non-APL patients with DIC are critically severe and early identification and timely intervention are necessary for them.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"45 S1","pages":"22-25"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Experience summary of coagulation rebalancing therapy for heat stroke-induced coagulopathy].","authors":"Q W Lin, X P Deng, H Q Liu, S K Yu, J C Song","doi":"10.3760/cma.j.cn121090-20241211-00557","DOIUrl":"10.3760/cma.j.cn121090-20241211-00557","url":null,"abstract":"<p><p>This case report describes the treatment process of a severe exertional heat stroke-induced coagulopathy in a 20-year-old firefighter. Through a comprehensive treatment strategy of five early and one prevention, including early cooling, early anticoagulation, early coagulation factor supplementation, early anti-inflammation, early blood purification, and prevention of complications, the patient was successfully treated. For the management of heat stroke-induced coagulopathy, based on the coagulation rebalancing strategy-namely anticoagulation combined with goal-directed replacement therapy, along with plasma diafiltration (PDF) treatment-the patient's coagulation function was effectively improved without any bleeding or thrombotic events. The patient's coagulation function returned to normal by day 4 of hospitalization, the tracheal tube was removed on day 6, transferred to the general ward after 11 days, and was discharged after 21 days of rehabilitation.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"45 S1","pages":"97-99"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10951119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
X Zhang, H B Meng, X L Meng, L Cui, R Y Cao, L Y Cai
{"title":"[Acute fatty liver of pregnancy with severe coagulopathy: a case report and review].","authors":"X Zhang, H B Meng, X L Meng, L Cui, R Y Cao, L Y Cai","doi":"10.3760/cma.j.cn121090-20241130-00509","DOIUrl":"10.3760/cma.j.cn121090-20241130-00509","url":null,"abstract":"<p><p>Acute fatty liver in pregnancy (Acute fatty liver of pregnancy, AFLP) in pregnancy is a relatively rare critical condition in obstetrics, which is difficult to distinguish in the early stages due to the non-specificity of its clinical manifestations. However, early recognition and timely termination of pregnancy is significant for the treatment of AFLP and is crucial to reduce mortality.This paper will report in detail a patient with AFLP at 37 weeks' gestation, mainly presenting with nausea and vomiting for 1 week and yellow skin for 2 days.Due to the relatively long course of the disease, the patient suffered a regrettable result of fetal death after emergency admission, and severe coagulation dysfunction, pulmonary edema, and pancreatitis occurred.The multidisciplinary team from the department of anesthesiology, ICU, hematology, blood transfusion department and so on, actively corrected coagulation disorders and multiple organ injuries in the emergency termination of pregnancy, and the patient had a good prognosis.The importance of early identification for the treatment of AFLP patients can be demonstrated, and the changes of coagulation function can be closely monitored to guide clinical treatment.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"45 S1","pages":"77-81"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Relapsed immune thrombotic thrombocytopenic purpura secondary to systemic lupus erythematosus: a case report and literature review].","authors":"H Tian, Y Li, H J He, X Y Xu, Z Q Yu, J Yin","doi":"10.3760/cma.j.cn121090-20241128-00489","DOIUrl":"10.3760/cma.j.cn121090-20241128-00489","url":null,"abstract":"<p><p><b>Objective:</b> To review the diagnosis and treatment process of a patient with relapsed immune thrombotic thrombocytopenic purpura (iTTP) secondary to systemic lupus erythematosus (SLE) and conduct a review of relevant literature, so as to provide a reference basis for the diagnosis and treatment of this disease. <b>Methods:</b> We retrospectively analyzed the diagnosis and treatment process of a patient with relapsed iTTP secondary to SLE who was admitted to the First Affiliated Hospital of Soochow University, and conducted a review of literature. <b>Results:</b> When the patient's iTTP relapsed, it was accompanied by moderate lupus activity, hypofibrinogenemia, renal insufficiency, and pulmonary infection. After adopting therapeutic plasma exchange (TPE), hormone pulse therapy, bortezomib, and comprehensive diagnosis and treatment by a multidisciplinary team, both the patient's iTTP and SLE were relieved. <b>Conclusion:</b> A comprehensive examination should be completed when diagnosing iTTP to rule out the possibility of combining with other autoimmune diseases. For relapsed and refractory cases, treatments targeting plasma cells, such as bortezomib, can be attempted.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"45 S1","pages":"12-17"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Coagulation disorder after severe traumatic brain injury: case report and literature review].","authors":"A L Liu, X Y Dong","doi":"10.3760/cma.j.cn121090-20241208-00545","DOIUrl":"10.3760/cma.j.cn121090-20241208-00545","url":null,"abstract":"<p><p><b>Objective:</b> To improve the understanding of the diagnosis and treatment of coagulation disorders after severe head trauma. <b>Methods:</b> One case of coagulation disorder after severe traumatic brain injury was reported and the literature was reviewed. <b>Results:</b> A 70-year-old female was admitted to the hospital with 10 hours of unconsciousness after head injury. The patient underwent emergency epidural hematoma removal, decompression, and epidural hematoma drainage, and then coagulation disorder occurred, followed by myocardial infarction with heart failure and venous thrombosis of the lower limbs. After multiple infusions of prothrombin complex, application of low molecular weight heparin and active anti-infective therapy, the patient eventually regained coagulation function. <b>Conclusion:</b> For trauma patients, especially those with head injuries, it is crucial to test coagulation as early as possible, take measures to maintain coagulation function, apply plasma or fibrinogen in the early stages, and be vigilant for later hypercoagulable states and thrombosis, with timely anticoagulation as needed.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"45 S1","pages":"57-62"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[CD19 CAR-T treatment for B-lymphoblastic lymphoma complicated with disseminated intravascular coagulation: a case report and literature review].","authors":"Y Y Li, P R Li, H W Jiang, H Mei","doi":"10.3760/cma.j.cn121090-20241202-00523","DOIUrl":"10.3760/cma.j.cn121090-20241202-00523","url":null,"abstract":"<p><p><b>Objective:</b> To explore the clinical manifestations, pathogenesis, and therapeutic approaches of disseminated intravascular coagulation (DIC) associated with chimeric antigen receptor T-cell (CAR-T) therapy for B-lymphoblastic lymphoma. <b>Methods:</b> Retrospective collection and analysis were conducted on the clinical data of a patient with B-lymphoblastic lymphoma who received CAR-T therapy in the Hematology Department of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, in April 2020. To review the literatures, Chinese databases (CNKI, Wanfang Database) and PubMed were searched form database inception up to November 2024 using the retrieval entries \"chimeric antigen receptor T-cell therapy\", \"CAR-T\", \"coagulation\", \"bleeding\", and \"thrombosis\" . <b>Results:</b> The patient, a 32-year-old male, diagnosed with B-lymphoblastic lymphoma for over 10 months, relapsed after three cycles of chemotherapy and allogeneic hematopoietic stem cell transplantation, with bone marrow cytology indicating 20.24% abnormal phenotype B-lineage precursor cells. After CAR-T cell infusion at a dose of 4×10(6)/kg, the patient developed grade 2 cytokine release syndrome (CRS) on day 2, nasal bleeding on day 4, high fever again on day 9, with worsening coagulation parameters, DIC and persistent hypofibrinogenemia. After treatment with tocilizumab, corticosteroids to counteract CRS, and active replacement therapy such as administration of blood product and fibrinogen, the patient's CRS and coagulation abnormalities gradually improved. The patient was followed up for 16 months regularly after CAR-T therapy, with CAR-T cells sustained and minimal residual disease remained negative as assessed by bone marrow flow cytometry. Subsequently, the patient stopped taking oral immunosuppressants on his own, which aggravated rejection reaction complicated with infection. The patient and his family requested to be discharged and lost the follow-up. A total of 20 relevant English articles and 6 Chinese articles were retrieved from the literature search. <b>Conclusion:</b> CAR-T-associated coagulopathy occurs alongside CRS. It is characterized by hypofibrinogenemia, and is life-threatening when progressing to DIC. Anti-CRS and replacement therapies have proven to be effective treatment strategies.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"45 S1","pages":"5-11"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Obstetrical disseminated intravascular coagulation: a case report and literature review].","authors":"Y F F Song, X Y Gong, B Zang","doi":"10.3760/cma.j.cn121090-20241129-00498","DOIUrl":"10.3760/cma.j.cn121090-20241129-00498","url":null,"abstract":"<p><p><b>Objective:</b> To report a case of obstetrical disseminated intravascular coagulation and discuss the treatment strategy of such cases. <b>Method:</b> The clinical data and treatment process of the patient with cardiac arrest and disseminated intravascular coagulation after amniotic fluid embolism was analyzed, and the related literature was reviewed. <b>Results:</b> Female, 36 years old, primigravida, was admitted to the hospital for delivery because of \"amenorrhea for more than 9 months, lower abdominal pain for 14 hours with a small amount of vaginal bleeding for 2 hours\", amniotic fluid embolism occurred after delivery, then cardiac arrest and DIC happened, which led to a large amount of blood loss, through the treatment methods of active circulatory and respiratory support, surgical interventions for two times, transfusion of erythrocytes, plasma, and cold precipitation, fibrinogen and other blood product for substitution, and early antifibrinolytic, the patient's life was successfully saved without irreversible organ function damage. <b>Conclusions:</b> For patients with obstetrical disseminated intravascular coagulation, in addition to treating the primary disease, it is necessary to correct coagulation function by component transfuse and antifibrinolytic as appropriate to improve the prognosis.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"45 S1","pages":"31-35"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D D Yu, X Y Dai, W Liu, Y H Wang, R C Yang, L Zhang, F Xue
{"title":"[Hereditary protein C deficiency presenting with predominant hemorrhagic symptoms: a case report and literature review].","authors":"D D Yu, X Y Dai, W Liu, Y H Wang, R C Yang, L Zhang, F Xue","doi":"10.3760/cma.j.cn121090-20241129-00494","DOIUrl":"10.3760/cma.j.cn121090-20241129-00494","url":null,"abstract":"<p><p><b>Objective:</b> To enhance the understanding of hereditary protein C deficiency. <b>Methods:</b> A case of a child with severe hereditary protein C deficiency, presenting with recurrent muscle bleeding as the primary clinical manifestation, was reported. The diagnostic and treatment were detailed, and relevant literature was reviewed. <b>Results:</b> The patient, a 2-year-old girl, was admitted with \"recurrent muscle hematomas for more than 2 years and intracranial hemorrhage for 3 months.\" Ecchymosis was observed on the skin of the left calf, with localized warmth detected on palpation. Muscle strength and tone in both lower limbs were within normal limits. The left thigh circumference measured 35.6 cm, compared to 29 cm on the right. Laboratory tests showed decreased fibrinogen, coagulation factor XIII activity, protein C activity, and significantly elevated fibrin degradation products (FDP) and D-dimer levels. Genetic testing identified compound heterozygous mutations in the PROC gene: c.565 (exon 7) C>T and c.983_988 (exon 7) del GCGAGC. The patient was diagnosed with hereditary protein C deficiency and disseminated intravascular coagulation (DIC). Treatment with fibrinogen supplementation, fresh frozen plasma, and anticoagulation therapy led to clinical improvement. <b>Conclusion:</b> The clinical manifestations of hereditary protein C deficiency are highly heterogeneous. While neonatal purpura fulminans is a common presentation, recurrent bleeding can also serve as a primary clinical manifestation.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"45 S1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
X W Song, M J Li, B J Ding, F D Wang, J X Hu, J Zhang, H Zhou
{"title":"[Perioperative treatment of a hemophilia patient with inhibitors using prothrombin complex concentrate followed by recombinant human coagulation factor Ⅶa: a case report].","authors":"X W Song, M J Li, B J Ding, F D Wang, J X Hu, J Zhang, H Zhou","doi":"10.3760/cma.j.cn121090-20250104-00006-1","DOIUrl":"https://doi.org/10.3760/cma.j.cn121090-20250104-00006-1","url":null,"abstract":"","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"45 S1","pages":"126"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[A case report of acquired factor ⅩⅢ deficiency following hip replacement surgery induced by sodium valproate and a literature review].","authors":"M X Zhang, H Bai, N Tang, Z Y Hong, W K Zhang","doi":"10.3760/cma.j.cn121090-20241130-00514","DOIUrl":"10.3760/cma.j.cn121090-20241130-00514","url":null,"abstract":"<p><p>Coagulation factor ⅩⅢ (FⅩⅢ) deficiency is a rare disease that is easily overlooked because routine coagulation tests do not reflect its deficiency. FⅩⅢ deficiency is divided into hereditary FⅩⅢ deficiency and acquired FⅩⅢ deficiency. The diagnosis of FⅩⅢ deficiency requires testing for FⅩⅢ activity and antigen, with confirmation through genetic testing. Due to the instability of fibrin clots caused by FⅩⅢ deficiency, the clinical features of FⅩⅢ deficiency include umbilical cord bleeding, soft tissue hematoma, recurrent miscarriage, cerebral hemorrhage, and delayed wound healing. Acquired FⅩⅢ deficiency can be caused by various reasons, and this article introduces a case of acquired FⅩⅢ deficiency in a patient after hip replacement surgery due to long-term use of sodium valproate.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"45 S1","pages":"110-113"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}