Disseminated intravascular coagulation (DIC)
DefinitionDisseminated intravascular coagulation (DIC) is a serious disorder in which the proteins that control blood clotting become over active.
Alternative NamesConsumption coagulopathy; DIC
Causes, incidence, and risk factorsWhen you are injured, proteins in the blood that form blood clots travel to the injury site to help stop bleeding. If you have DIC, these proteins become abnormally active throughtout the body. This may be due to inflammation, infection, or cancer.Small blood clots form in the blood vessels. Some of these clots can clog the vessels and cut off blood supply to organs such as the liver, brain, or kidneys. Lack of blood flow can damage the organ and it may stop working. Over time, the clotting proteins in your blood are "used up." When this happens, you have a higher risk for serious bleeding, even from a minor injury or without injury. You mlay also have bleeding that starts on its own. The disease can also cause healthy red blood cells to break up when they thravel through the small vessesl that are filled with clots. Risk factors for DIC include:Blood transfusion reactionCancer, especially certain types of leukemiaInflammation of the pancreas (pancreatitis)Infection in the blood, especially by bacteria or fungusLiver diseasePregnancy complications (such as placenta that is left behind after delivery)Recent surgery or anesthesiaSevere tissue injury (as in burns and head injury)
SymptomsBleeding, possibly from many sites in the bodyBlood clotsBruisingDrop in blood pressure
Signs and testsYou may have the following tests:Complete blood count with blood smear examFibrin degration productsPartial thromboplastin time (PTT)
Prothrombin time (PT)
TreatmentThe goal is to determine and treat the cause of DIC.There is no specific treatment for DIC. Treatments may inlcude:Plasma transfusions to replace blood clottting factorsBlood thinner medicine (heparin) to prevent blood clotting
Expectations (prognosis)The outcome depends on what is causing the disorder. DIC can be life-threatening.
ComplicationsBleedingLack of blood flow to the arms, legs, or vital organsStroke
Calling your health care provider
Go to the emergency room or call 911 if you have bleeding that won't stop.
Get prompt tratment for conditions known to bring on this disorder.
References Schafer AI. Hemorrhagic disorders: disseminated intravascular coagulation, liver failure, and vitamin K deficiency. In: Goldman L, Ausiello D, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 178.
Liebman HA, Weitz IC. Disseminated intravascular coagulation. In: Hoffman R, Benz EJ, Shattil SS, et al., eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 132.