Disseminated intravascular coagulation

Disseminated intravascular coagulation
Other namesDisseminated intravascular coagulopathy, consumptive coagulopathy, defibrination syndrome[1]
Micrograph showing acute thrombotic microangiopathy due to DIC in a kidney biopsy. A clot is present in the hilum of the glomerulus (center of image).
SpecialtyHematology
SymptomsChest pain, shortness of breath, leg pain, problems speaking, problems moving part of the body, bleeding[1]
ComplicationsOrgan failure[2]
TypesAcute, chronic[1]
CausesSepsis, surgery, major trauma, cancer, complications of pregnancy, snake bites, frostbite, burns[1]
Diagnostic methodBlood tests[2]
Differential diagnosisThrombotic thrombocytopenic purpura, hemolytic-uremic syndrome[1]
TreatmentDirected at the underlying condition[3]
MedicationPlatelets, cryoprecipitate, fresh frozen plasma, heparin[2]
Prognosis20–50% risk of death[4]
Frequency1% of people admitted to hospital[4]

Disseminated intravascular coagulation (DIC) is a condition in which blood clots form throughout the body, blocking small blood vessels.[1] Symptoms may include chest pain, shortness of breath, leg pain, problems speaking, or problems moving parts of the body.[1] As clotting factors and platelets are used up, bleeding may occur.[1] This may include blood in the urine, blood in the stool, or bleeding into the skin.[1] Complications may include organ failure.[2]

Relatively common causes include sepsis, surgery, major trauma, cancer, and complications of pregnancy.[1] Less common causes include snake bites, frostbite, and burns.[1] There are two main types: acute (rapid onset) and chronic (slow onset).[1] Diagnosis is typically based on blood tests.[2] Findings may include low platelets, low fibrinogen, high INR, or high D-dimer.[2]

Treatment is mainly directed towards the underlying condition.[2][3] Other measures may include giving platelets, cryoprecipitate, or fresh frozen plasma.[2] Evidence to support these treatments, however, is poor.[2] Heparin may be useful in the slowly developing form.[2] About 1% of people admitted to hospital are affected by the condition.[4] In those with sepsis, rates are between 20% and 50%.[4] The risk of death among those affected varies from 20% to 50%.[4]

  1. ^ a b c d e f g h i j k l "Disseminated Intravascular Coagulation | NHLBI, NIH". www.nhlbi.nih.gov. Retrieved 20 December 2017.
  2. ^ a b c d e f g h i j "Disseminated Intravascular Coagulation (DIC) - Hematology and Oncology". Merck Manuals Professional Edition. September 2016. Retrieved 20 December 2017.
  3. ^ a b Levi M (2007). "Disseminated Intravascular Coagulation". Critical Care Medicine. 35 (9): 2191–2195. doi:10.1097/01.CCM.0000281468.94108.4B. PMID 17855836. S2CID 7158989.
  4. ^ a b c d e Gando S, Levi M, Toh CH (2 June 2016). "Disseminated intravascular coagulation". Nature Reviews Disease Primers. 2: 16037. doi:10.1038/nrdp.2016.37. PMID 27250996. S2CID 4059451.