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Disseminated intravascular coagulopathy

Disseminated intravascular coagulation
Synonyms Disseminated intravascular coagulopathy, consumptive coagulopathy, defibrination syndrome
Acute thrombotic microangiopathy - pas - very high mag.jpg
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 Haematology
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
Classification
External resources

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.

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 chronic 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%.


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