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Disseminated intravascular coagulation (DIC)
Definition
Disseminated intravascular coagulation (DIC) is a serious disorder in which the proteins that control blood clotting become abnormally active.
Alternative Names
Consumption coagulopathy
Causes
Normally when you are injured, certain proteins in the blood become activated and travel to the injury site to help stop bleeding. However, in persons with DIC, these proteins become abnormally active. This often occurs due to inflammation, infection, or cancer.
Small blood clots form in the blood vessels. Some of these clots can clog up the vessels and cut off blood supply to various organs such as the liver, brain, or kidney. These organs will then be damaged and may stop functioning.
Over time, the clotting proteins are consumed or "used up." When this happens, the person is then at risk for serious bleeding, even from a minor injury or without injury. This process may also break up healthy red blood cells.
Risk factors for DIC include:
- Blood transfusion reaction
- Cancer, especially certain types of leukemia
- Infection in the blood by bacteria or fungus
- Liver disease
- Pregnancy complications (such as placenta that is left behind after delivery)
- Recent surgery or anesthesia
- Sepsis (a serious infection)
- Severe tissue injury (as in burns and head injury)
Symptoms
- Bleeding, possibly from multiple sites in the body
- Blood clots
- Bruising
- Drop in blood pressure
Exams and Tests
The following tests may be done:
- Complete blood count with blood smear examination
- Fibrin degradation products
- Partial thromboplastin time (PTT)
- Platelet count
- Prothrombin time (PT)
- Serum fibrinogen
Treatment
The goal is to determine and treat the cause of DIC.
Blood clotting factors may be replaced with plasma transfusions. Platelet transfusions can raise the blood count. Heparin, a medication used to prevent clotting, is sometimes used to interrupt clotting events.
Outlook (Prognosis)
The outcome depends on what is causing the disorder, but DIC can be life-threatening.
Possible Complications
- Bleeding
- Lack of blood flow to the arms, legs, or vital organs
- Stroke
When to Contact a Medical Professional
Go to the emergency room or call 911 if you have bleeding that won't stop.
Prevention
Get prompt treatment 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. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 181.
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.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
