Tessier-Marteau A, Cruguel S le, Grand F, Asfar P, Zandecki M, Macchi L
Laboratoire d'hématologie, CHU Angers, Service de réanimation, CHU d'Angers.
Ann Biol Clin (Paris). 2009 Sep-Oct;67(5):569-72. doi: 10.1684/abc.2009.0367.
Peripheral gangrene with disseminated intravascular coagulation (DIC) during severe Plasmodium falciparum malaria has already been described but is unfrequent. We report here the case of a 62-year-old man admitted in the intensive care unit of our hospital for severe Plasmodium falciparum malaria with disseminated intravascular coagulation (DIC) and peripheral gangrene of his toes that needed amputation. Pathophysiological mechanisms leading to DIC in malaria can be used as a model to explain the relation between coagulation and inflammation. Therapeutic targeting of coagulation, by acting on inflammation, could be useful to limit the coagulation-inflammation cycle.
严重恶性疟原虫疟疾期间出现伴有弥散性血管内凝血(DIC)的外周坏疽已有报道,但并不常见。我们在此报告一例62岁男性患者,因严重恶性疟原虫疟疾伴弥散性血管内凝血(DIC)及脚趾外周坏疽入住我院重症监护病房,其脚趾坏疽需要截肢。导致疟疾中DIC的病理生理机制可作为解释凝血与炎症之间关系的模型。通过作用于炎症来靶向治疗凝血,可能有助于限制凝血-炎症循环。