Clinical and laboratory findings in DIC

• DIC is an acute or subacute thrombohemorrhagic d/o that is ALWAYS secondary to something else

• There is systemic activation of coagulation and formation of microthrombi, which uses up all of the platelets, fibrin, and coagulation factors; there is also systemic activation of fibrinolysis

• Clinical findings

  • Patients may present with signs of tissue hypoxia and infarction or with those of a hemorrhagic d/o

  • Spherocytes, schizocytes, and other fragmented RBCs can be seen on peripheral smear because fibrin is being deposited in the microvasculature, leading to microangiopathic hemolysis of RBCs

• Lab findings

  • Variable

  • May include combinations of prolongations of PT, aPTT, bleeding time, and thrombin time, thrombocytopenia, decreased fibrinogen, and elevated fibrin degradation products

  • D-dimer will be elevated

    • D-dimer is elevated when pre-formed clots are busted (i.e., active clotting + clot lysis)

    • D-dimer is elevated in DIC, pathologic thrombosis, and embolism

  • Fibrin monomers

    • These will also be elevated (evidence of active clotting)

    • Monomers are normally polymerized by factor XIII; with systemic or localized clotting, some of the monomers are carried to the bloodstream before polymerization can occur

• Treatment mostly involves correcting the underlying d/o, replacement of clotting factors and platelets, and/or anticoagulant therapy; prognosis is variable and largely depends on the underlying d/o

Category: Medical Subject Notes , Pathology Notes