DISSEMINATED INTRAVASCULAR COAGULATION (DIC)
Andy Nguyen,M.D./ UT-Medical School at Houston, Pathology/
Last Revision on: 12/9/96
- Pathological Basis:
- DIC occurs when there is generalized activation of the
coagulation system in vivo, resulting in conversion of
fibrinogen to fibrin. After formation of a fibrin clot,
there is also generation of plasmin, which lyses the
fibrin clot. DIC may be initiated by several mechanisms.
The most common mechanism is the escape of tissue
substance into circulating blood. Clinical states
associated with DIC include: obstetric complications,
tissue trauma, hemolysis, neoplastic diseases, sepsis,
etc.
- It should be stressed that DIC may have an abrupt or
insidious onset, may be active or chronic, may be
compensated or decompensated depending on the degree of
consumption and utilization of the various procoagulants
and platelets.
- The best diagnostic evidence of DIC is the demonstration
of high serum level of fibrin split product (FSP) or D-Dimer.
- Treatment:
- Manage underlying disease.
- FFP or cryoprecipitate, platelet concentrates in cases
bleeding is the primary clinical problem.
Diagnostic Criteria:
- Plt_count:abnormal(low)
- FSP or D-Dimer:abnormal
- Presence of schistocytes in peripheral blood smear
- Risk_factors_for_DIC(tissue_trauma,sepsis,malignancy,etc)