Shimamoto Y, Ohta A, Sano M, Suga K, Yamaguchi M
Department of Internal Medicine, Saga Medical School, Japan.
Am J Hematol. 1993 Feb;42(2):191-5. doi: 10.1002/ajh.2830420210.
To analyze the outcome of systemic lupus erythematosus (SLE) associated with acute disseminated intravascular coagulation (DIC) and also to clarify the clinical factor(s) contributing to the outcome, we retrospectively investigated 120 SLE patients treated between 1981 and 1991. Eight of these patients (6.7%) developed acute DIC; four recovered and the other four died within 2 weeks of onset. Infection preceded acute DIC in all these patients. Acute DIC associated with atypical pneumonia was always fatal, while the patients with pharyngitis or urinary tract infection survived when they were treated adequately. Comparison of the dead and surviving groups revealed that the activity of SLE before the onset of DIC, the severity of DIC, and the treatment given for DIC and the coexistent infection were not significantly related to a fatal outcome. However, severe infection such as atypical pneumonia in patients with secondary immunodeficiency was likely to be fatal irrespective of the presence of DIC.
为分析系统性红斑狼疮（SLE）合并急性弥散性血管内凝血（DIC）的结局，并阐明影响结局的临床因素，我们回顾性调查了1981年至1991年间接受治疗的120例SLE患者。其中8例患者（6.7%）发生急性DIC；4例康复，另外4例在发病后2周内死亡。所有这些患者在急性DIC之前均有感染。合并非典型肺炎的急性DIC总是致命的，而咽炎或尿路感染患者若得到充分治疗则存活。对死亡组和存活组的比较显示，DIC发作前SLE的活动度、DIC的严重程度、针对DIC和并存感染的治疗与致命结局无显著相关性。然而，继发性免疫缺陷患者的严重感染如非典型肺炎，无论是否存在DIC都可能致命。
