Disseminated intravascular coagulation

Keywords: DIC

Causes

Appropriate Tests

 

Full blood count including Platelet count, Blood film, Thrombin time, Fibrin degradation products (D Dimer), Fibrinogen assay to establish diagnosis. Platelet count, APTT, Prothrombin time, INR, Fibrinogen assay to monitor course and therapy.

NB. The quantitative (latex) D Dimer test is used for detection of fibrin degradation products. Its use and interpretation must be differentiated from the sensitive qualitative D Dimer used in evaluation of a possible Deep vein thrombosis or Pulmonary embolism.

Acute severe DIC

 

Obstetric syndromes

See Peripartum bleeding under Pregnancy.

Septicaemia, especially

  • Gram-negative bacteria eg
    • Escherichia coli
    • Neisseria meningitidis
    • Dengue fever

 

Massive trauma

 

Acute promyelocytic leukaemia

See Acute leukaemia.

Acute intravascular haemolysis, especially

  • ABO-incompatible transfusion

 

See Immediate haemolytic transfusion reaction under Blood transfusion.

Prostate surgery

 

Asphyxia

 

Snake bite

 

Sub-acute/chronic DIC

See also Microangiopathic haemolysis.

Advanced/metastatic carcinoma, especially

  • Mucinous adenocarcinoma
  • Severe/advanced liver disease
Presence of DIC can often be predicted from the clinical context; confirmatory tests may not be required.

Retained dead fetus

Monitoring is important (Platelet count, FDP, Fibrinogen assay) until fetus delivered, as acute and severe DIC may develop.

Haemangiomas (giant)