Disseminated intravascular coagulation (DIC)
Definition
Disseminated intravascular coagulation (DIC) is a serious disorder in which the proteins that control blood clotting becomeover active.
Alternative Names
Consumption coagulopathy; DIC
Causes
When 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 throughout the body. This may be dueto 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 may also have bleeding that starts on its own.The disease can also cause healthy red blood cells to break up when they travel through the small vessels that are filled with clots.
Risk factors for DIC include:
- Blood transfusion reaction
- Cancer, especially certain types of leukemia
- Inflammation of the pancreas (pancreatitis)
- Infection in the blood, especially by bacteria or fungus
- Liver disease
- Pregnancy complications (such as placenta that is left behind after delivery)
- Recent surgery or anesthesia
- Severe tissue injury (as in burns and head injury)
Symptoms
- Bleeding, possibly from many sites in the body
- Blood clots
- Bruising
- Drop in blood pressure
Exams and Tests
You may have the following tests:
- Complete blood count with blood smear exam
- Fibrin degradation products
- Partial thromboplastin time (PTT)
- Prothrombin time (PT)
- Serum fibrinogen
Treatment
The goal is to determine and treat thecause of DIC.
There is no specific treatment for DIC. Treatments may include:
- Plasma transfusions to replace blood clotting factors
- Blood thinner medicine (heparin) to prevent blood clotting
Outlook (Prognosis)
The outcome depends on what is causing the disorder. 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. 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.
Reviewed By: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.
