書誌事項
- タイトル別名
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- Waterhouse-Friderichsen syndrome with excessive hypercytokinemia.
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We report a case of Waterhouse-Friderichsen syndrome with excessive hypercytokinemia in a previously healthy 59-year-old man. The patient complained of a 20 hour history of fever and multiple pain. He was in shock on arrival and diffuse petechiae were observed on his trunk. The laboratory data evaluated metabolic acidosis (BE-16.9mmol/l), leukopenia (WBC 3, 900/μl) with a shift to the lef, obvious thrombocytopenia (1.8×104/μl), hypoglycemia (49mg/dl), and disseminated intravascular coagulation (DIC). Abdominal computerized tomography (CT) scan showed bilateral adrenal swelling and irregular shape of left gland. Immediately he developed adult respiratory distress syndrome (ARDS), then died 17.5 hours after arrival without recovery from shock. On microbiological investigation, group 12 (Danish classification) of penicillin sensitive Streptococcus pneumniae was detected in his blood. The serum data demonstrated excessive hypercytokinemia (interleukin [IL]-1β 1, 010pg/ml, IL-6 1.03×106pg/ml). An autopsy revealed massive hemorrhagic necrosis and fibrinous thrombosis in a half of bilateral adrenal cortex and DIC in multiple organs, while the spleen was intact. Neither focus of original infection nor what aggravated the infection was clear.
収録刊行物
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- 日本救急医学会雑誌
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日本救急医学会雑誌 9 (10), 545-550, 1998
一般社団法人 日本救急医学会
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詳細情報 詳細情報について
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- CRID
- 1390282679347361408
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- NII論文ID
- 130003626336
- 10005648418
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- NII書誌ID
- AN10284604
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- ISSN
- 18833772
- 0915924X
- http://id.crossref.org/issn/0915924X
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- 本文言語コード
- ja
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- データソース種別
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- JaLC
- Crossref
- CiNii Articles
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- 抄録ライセンスフラグ
- 使用不可