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[Disseminated intravascular coagulation, 113 cases, including 17 children with fulminant purpura]
Insights
Fulminant purpura, a severe form of disseminated intravascular coagulation (DIC), presents distinct clinical features in children. In Mexico, infections, often originating in the digestive tract, are the primary cause of DIC.
Area of Science:
- Pediatrics
- Hematology
- Infectious Diseases
Context:
- A study conducted at the Hospital Infantil de México between 1964 and 1971.
- Investigated 113 children diagnosed with disseminated intravascular coagulation (DIC).
- Included 17 specific cases of fulminant purpura, comparing findings with international data.
Purpose:
- To delineate the characteristics and etiological factors of fulminant purpura and DIC in pediatric patients.
- To establish diagnostic criteria for fulminant purpura versus general DIC.
- To compare Mexican epidemiological data with global reports.
Summary:
- Fulminant purpura develops after a latency period post-causal illness and is not directly caused by septicemia.
- This condition presents clearly in infants and children, with a notable lethality index of 17.7%.
- In Mexico, 88% of DIC cases were infection-related, with 68% originating from the digestive tract. Diagnostic differentiation relies on clinical presentation for fulminant purpura and laboratory tests for DIC.
Impact:
- Highlights the significant role of infections, particularly gastrointestinal, in pediatric DIC in Mexico.
- Emphasizes the need for distinct diagnostic approaches for fulminant purpura and general DIC.
- Provides valuable epidemiological insights into a critical pediatric condition for clinical and research communities.
Abstract:
Between 1964 and 1971, 113 children with the syndrome of disseminated intravascular coagulation were studied at the Hospital Infantil de México, including 17 cases with the diagnosis of fulminant purpura. Comparison was established with reports from foreign institutions. The following conclusions are offered: Fulminant purpura appears after a period of latency following the causal disease. It is not caused by septicemia; shows a clear picture in infants, preschool and school children, with letality index of 17.7%. In Mexico, DIC was caused by infection in 88% of the cases and in 68% of them, the infection started in the digestive tract. The diagnosis of fulminant purpura is based on the clinical picture, while in DIC, the diagnosis must also be based on laboratory tests unless one half of the diagnoses be missed.