Disseminated Intravascular Coagulation (DIC)

Definition

Widespread inappropriate intravascular deposition of fibrin with consumption of coagulation factors and platelets occurs as a consequence of many disorders which release procoagulant material into the circulation and cause widespread endothelial damage or platelet aggregation.

Signs & Symptoms

Generalized bleeding, sometimes peripheral gangrene or cerebral ischaemia.

Causes

Increase tissue factor activity due to damaged tissues of tumor cells or in response to proinflammatory cytokines. Could be caused by infections, malignancy, obstetric complications, hypersensitive reactions, widespread tissue damage, vascular abnormalities.

Peripheral blood characteristics

Hemolytic anemia with fragmentation of the red cells.

Important investigations & related results

Low platelet count and fibrinogen concentration, prolonged TT, high levels of fibrin degradation products, prolonged PT and APTT prolonged in the acute syndrome.

Treatment & management

Fresh frozen plasma and platelet concentrates, cryoprecipitate for bleeding, heparin or antiplatelet drugs for thrombosis.

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