Disseminated intravascular coagulation
Disseminated intravascular coagulation (DIC) is a condition in which blood clots form throughout the body, blocking small blood vessels. Symptoms may include chest pain, shortness of breath, leg pain, problems speaking, or problems moving parts of the body. As clotting factors and platelets are used up, bleeding may occur. This may include blood in the urine, blood in the stool, or bleeding into the skin. Complications may include organ failure.
| Disseminated intravascular coagulation | |
|---|---|
| Other names | Disseminated intravascular coagulopathy, consumptive coagulopathy, defibrination syndrome |
| 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). | |
| Specialty | Hematology |
| Symptoms | Chest pain, shortness of breath, leg pain, problems speaking, problems moving part of the body, bleeding |
| Complications | Organ failure |
| Types | Acute, chronic |
| Causes | Sepsis, surgery, major trauma, cancer, complications of pregnancy, snake bites, frostbite, burns |
| Diagnostic method | Blood tests |
| Differential diagnosis | Thrombotic thrombocytopenic purpura, hemolytic-uremic syndrome |
| Treatment | Directed at the underlying condition |
| Medication | Platelets, cryoprecipitate, fresh frozen plasma, heparin |
| Prognosis | 20–50% risk of death |
| Frequency | 1% of people admitted to hospital |
Relatively common causes include sepsis, surgery, major trauma, cancer, and complications of pregnancy. Less common causes include snake bites, frostbite, and burns. There are two main types: acute (rapid onset) and chronic (slow onset). Diagnosis is typically based on blood tests. Findings may include low platelets, low fibrinogen, high INR, or high D-dimer.
Treatment is mainly directed towards the underlying condition. Other measures may include giving platelets, cryoprecipitate, or fresh frozen plasma. Evidence to support these treatments, however, is poor. Heparin may be useful in the slowly developing form. About 1% of people admitted to hospital are affected by the condition. In those with sepsis, rates are between 20% and 50%. The risk of death among those affected varies from 20% to 50%.