Disseminated Intravascular Coagulation

• Published in: American journal of clinical pathology Vol. 146; no. 6; pp. 670 - 680
• Main Authors: Boral, Benjamin M., Williams, Dennis J., Boral, Leonard I.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-12-2016
• Subjects: Adult; Blood Coagulation - physiology; Blood platelets; Diagnosis, Differential; Disseminated intravascular coagulation; Disseminated Intravascular Coagulation - blood; Disseminated Intravascular Coagulation - diagnosis; Emergency medical care; Endothelium; Family medical history; Hematology; Hemorrhage; Humans; Intensive care; Laboratories; Liver cirrhosis; Male; Patients; Physiology; Sepsis; Thrombosis; Vital signs; Thrombocytopenia; Thrombin; Thrombi; Hemorrhage; Coagulopathy; DIC
• ISSN: 0002-9173; 1943-7722
• DOI: 10.1093/ajcp/aqw195

Objectives: To provide a review of the definition, pathophysiology, differential diagnosis, and treatment of disseminated intravascular coagulation (DIC).
Methods: A case scenario and a review of the literature related to the pertinent facts concerning DIC are provided.
Results: DIC is a systemic pathophysiologic process and not a single disease entity, resulting from an overwhelming activation of coagulation that consumes platelets and coagulation factors and causes microvascular fibrin thrombi, which can result in multiorgan dysfunction syndrome from tissue ischemia. Some conditions associated with acute DIC include septic shock, exsanguinating trauma, burns, or acute promyelocytic leukemia.
Conclusions: The massive tissue factor stimulus results in excess intravascular thrombin, which overcomes the anticoagulant systems and leads to thrombosis. Because of consumption of coagulation factors and platelets, DIC also has a hemorrhagic phase. Treatment of the bleeding patient with DIC is supportive with the use of blood components.