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Disseminated intravascular coagulation (DIC)

Consumption coagulopathy; DIC

Disseminated intravascular coagulation (DIC) is a serious disorder in which the proteins that control blood clotting become overactive.

Causes

When you are injured, proteins in the blood that form blood clots travel to the injury site to help stop bleeding. If these proteins become abnormally active throughout the body, you could develop DIC. The underlying cause is usually due to inflammation, infection, or cancer.

In some cases of DIC, small blood clots form in the blood vessels. Some of these clots can clog the vessels and cut off the normal blood supply to organs such as the liver, brain, or kidneys. Lack of blood flow can damage and cause major injury to the organs.

In other cases of DIC, the clotting proteins in your blood are consumed. When this happens, you may have a high risk of serious bleeding, even from a minor injury or without injury. You may also have bleeding that starts spontaneously (on its own). The disease can also cause your healthy red blood cells to fragment and 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)
  • Large hemangioma (a blood vessel that is not formed properly)

Symptoms

Symptoms of DIC may include any of the following:

  • Bleeding, from many sites in the body
  • Blood clots
  • Bruising
  • Drop in blood pressure
  • Shortness of breath
  • Confusion, memory loss or change of behavior
  • Fever

Exams and Tests

You may have any of the following tests:

Treatment

There is no specific treatment for DIC. The goal is to determine and treat the underlying cause of DIC.

Supportive treatments may include:

  • Plasma transfusions to replace blood clotting factors if a large amount of bleeding is occurring.
  • Blood thinner medicine (heparin) to prevent blood clotting if a large amount of clotting is occurring.

Outlook (Prognosis)

Outcome depends on what is causing the disorder. DIC can be life threatening.

Possible Complications

Complications from DIC may include:

  • 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 does not stop.

Prevention

Get prompt treatment for conditions known to bring on this disorder.

References

Napotilano M, Schmair AH, Kessler CM. Coagulation and fibrinolysis. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. St Louis, MO: Elsevier; 2017:chap 39.

Schafer AI. Hemorrhagic disorders: disseminated intravascular coagulation, liver failure, and vitamin K deficiency. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 175.

    • Blood clot formation

      Blood clot formation - illustration

      Blood clotting normally occurs when there is damage to a blood vessel. Platelets immediately begin to adhere to the cut edges of the vessel and release chemicals to attract even more platelets. A platelet plug is formed, and the external bleeding stops. Next, small molecules, called clotting factors, cause strands of blood-borne materials, called fibrin, to stick together and seal the inside of the wound. Eventually, the cut blood vessel heals and the blood clot dissolves after a few days.

      Blood clot formation

      illustration

    • Meningococcemia on the calves

      Meningococcemia on the calves - illustration

      Meningococcemia is a life-threatening infection that occurs when the meningococcus, Neisseria meningitidis, invades the blood stream. Bleeding into the skin (petechiae and purpura) may occur. The tissue in areas may die (become necrotic or gangrenous). If the person survives, the areas heal with scarring.

      Meningococcemia on the calves

      illustration

    • Blood clots

      Blood clots - illustration

      Blood clots (fibrin clots) are the clumps that result when blood coagulates.

      Blood clots

      illustration

      • Blood clot formation

        Blood clot formation - illustration

        Blood clotting normally occurs when there is damage to a blood vessel. Platelets immediately begin to adhere to the cut edges of the vessel and release chemicals to attract even more platelets. A platelet plug is formed, and the external bleeding stops. Next, small molecules, called clotting factors, cause strands of blood-borne materials, called fibrin, to stick together and seal the inside of the wound. Eventually, the cut blood vessel heals and the blood clot dissolves after a few days.

        Blood clot formation

        illustration

      • Meningococcemia on the calves

        Meningococcemia on the calves - illustration

        Meningococcemia is a life-threatening infection that occurs when the meningococcus, Neisseria meningitidis, invades the blood stream. Bleeding into the skin (petechiae and purpura) may occur. The tissue in areas may die (become necrotic or gangrenous). If the person survives, the areas heal with scarring.

        Meningococcemia on the calves

        illustration

      • Blood clots

        Blood clots - illustration

        Blood clots (fibrin clots) are the clumps that result when blood coagulates.

        Blood clots

        illustration

      Tests for Disseminated intravascular coagulation (DIC)

       

      Review Date: 10/21/2017

      Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

      The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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