[Disseminated intravascular coagulation in solid tumours]

PARANEOPLASTIC SYNDROMES REVIEW: THE GREAT FORGOTTEN ONES

Paraneoplastic syndromes (PNS) are a group of disorders that can affect the oncologic patient, and which are not directly attributable to tumour invasion, tumour compression or metastasis. In fact, they are due to tumour secretion of functional hormones or peptides or are related to immune cross-reactivity with the host tissue. These syndromes are called paraneoplastic because the components that cause them do not derive from the organ or tissue of origin, but from the neoplasm suffered by the patient. It is estimated that 10-15% of people with cancer suffer from a PNS.(1) PNS is the second direct cause of death (27% of cases) in cancer patients, after cancer itself. Consequently, it is of remarkable importance to recognize and treat SPNs specifically.(2) In view of the above, the aim of this article is to review the state of the art in neurological, haematological, endocrine, and dermatological paraneoplastic syndromes. It is a review in which the most relevant PNS and their symptomatology are described, inquiring into their diagnosis and treatment.

Blood Component Utilization for Disseminated Intravascular Coagulation (DIC) Cases with Respect to Underlying Condition

To understand transfusion requirement in DIC with respect to (wrt) underlying cause. Patients' details were analyzed using parameters like yearly requirement, hemoglobin (Hb) and blood components utilization wrt age, sex and cause of DIC. Total 1931 DIC cases from 167 hospitals received 21,153 blood units including whole blood, red cell concentrate fresh frozen plasma, random donor platelets, single donor platelets and cryoprecipitate from year 2001 to 2013. Significant risk of DIC was for females compared to males (p < 0.0001). Whole blood utilization was 25.5 % in 2001 which reduced to 1.2 % in 2013. Mean ± SD Hb concentration was 8.6 ± 3.0 in females and 9.8 ± 3.2 g/dL in males. The lowest mean Hb was 7 g/dL in female DIC cases having malignancy. Septicemia was the major cause of DIC followed by obstetric complications. The highest requirement was for trauma associated with septicemia, requiring 35 units/case. Combination of two or more underlying causes for DIC increased the blood component requirement.