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Disseminated intravascular coagulation in Still's disease
1Department of Medicine, Fitzsimons Army Medical Center, Aurora, CO 80045-5001.
Seminars in Arthritis and Rheumatism
|December 1, 1994
Summary
Still's disease can lead to a serious bleeding complication called disseminated intravascular coagulation (DIC). This case highlights a rare fatal instance of DIC in Still's disease, even without drug triggers.
Area of Science:
- Rheumatology
- Hematology
- Pathology
Background:
- Still's disease, a rare inflammatory disorder, typically presents with arthritis, fever, and rash.
- Thrombocytosis is a common finding, but complications involving coagulation are less understood.
Observation:
- This report details a patient with Still's disease who developed thrombocytopenia secondary to disseminated intravascular coagulation (DIC).
- Only 15 previous cases of DIC complicating Still's disease were found in the literature, often linked to high-dose salicylates or gold therapy.
- The described patient is notably the second to develop DIC without drug therapy and the fourth to succumb to this complication.
Findings:
- Disseminated intravascular coagulation (DIC) is a rare but severe complication of Still's disease.
- Drug therapy, particularly high-dose salicylates and gold, is frequently associated with DIC in these patients.
- Fatal outcomes from DIC in Still's disease, especially in the absence of drug triggers, are uncommon.
Implications:
- Understanding the pathogenesis of DIC in Still's disease is crucial for early recognition and management.
- This case underscores the need for vigilance regarding coagulation abnormalities in patients with Still's disease, even those not on specific drug regimens.
- Further research into the mechanisms underlying DIC in Still's disease may lead to improved treatment strategies and patient outcomes.