Disseminated Intravascular Coagulation: Pathophysiology, Laboratory Findings, and Diagnosis

Introduction

Disseminated Intravascular Coagulation (DIC) is a complex systemic disorder characterized by uncontrolled clotting and bleeding. It is associated with various underlying conditions and requires prompt identification and management.

Pathophysiology

DIC occurs due to excessive activation of the coagulation cascade, leading to microvascular thrombosis and subsequent consumption of clotting factors, resulting in widespread bleeding. Common causes include sepsis, trauma, malignancies, and obstetric complications.

Laboratory Investigations

• Prothrombin Time (PT) and Activated Partial Thromboplastin Time (aPTT): Elevated due to clotting factor consumption.
• D-Dimer: Increased, indicating fibrinolysis.
• Platelet Count: Decreased due to consumption.
• Fibrinogen: Reduced due to excessive utilization.
• Peripheral Blood Smear: Presence of schistocytes, indicating microangiopathic hemolysis.

Key Diagnostic Tests

DIC diagnosis is primarily clinical and confirmed via laboratory findings. A scoring system integrating platelet count, PT, fibrinogen, and D-dimer levels aids in the diagnosis.

Conclusion

Early recognition and management of DIC are crucial. Treatment involves addressing the underlying cause, replacing depleted clotting factors, and supporting organ function.