Clinical and laboratory findings in DIC

on 9.2.09 with 0 comments

  • 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



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