Abstract
The most usual association of multiple organ failure (MOF) is with sepsis. And sepsis in one of the important primary disease of disseminated intravascular coagulation (DIC). Fourteen patients with DIC in sepsis and 13 patients with DIC in cancer were found during past 15 years in our institution. A comparative study of both groups was retrospectively done on their clinicopathological records. The characteristic findings obtained from the septic patients compared to the patients with cancer were as follows: 1) frequent association of shock (p<0.005) and organ failure (p<0.05), and 2) a decrease in components of complement such as C4 (p<0.05) and C3 (p<0.05). There was no difference in DIC score and the number of patients with microthrombi in vital organs at autopsy.
Making a hemostatic disorder of mild course of DIC in animal experiment using dog, endotoxin induced a significant decrease in C3 and a development of marked metabolic acidosis followed by an increase and a development of marked metabolic acidosis followed by an increase in GOT, GPT, BUN and creatinine in serum. On the other hand, thromboplastin did not induce these changes, though coagulation and fibrinolytic abnormalities occurred similar to those in dogs administered endotoxin.
Therefore, the organ failure found in DIC may not be always due to mechanical occlusion of microcirculation caused by fibrin thrombi. The activation of complement by endotoxin may produce biologically active substances which collaborate with a direct toxicity of endotoxin on cells and might result severe cellular damage of vital organs.
