Disseminated intravascular coagulation laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
Laboratory findings consistent with the diagnosis of [[DIC]] include decreased platelets, [[fibrin degradation products]] | Laboratory findings consistent with the diagnosis of [[DIC]] include decreased platelets, increased [[fibrin degradation products]], increased [[D-dimer]], increased [[bleeding time]], and decreased [[fibrinogen]] levels. Peripheral smear shows [[schistocytes]] and [[RBC]] fragments in ~ 50%, mild [[reticulocytosis]], [[leukocytosis]], and [[thrombocytopenia]] with an increased population of young [[platelets]] (due to increased destruction and turnover). Clotting factors include normal [[prothrombin time]] and [[partial thromboplastin time]] in up to 50% of patients (due to higher circulating levels of [[clotting factors]] such as [[factor Xa]] and [[thrombin]]), elevated [[fibrin]] and [[fibrinogen]] degradation products. [[D-dimer]] more sensitive and specific for [[DIC]]. [[Antithrombin]] levels have become a key test for diagnosing and monitoring therapy in [[DIC]]. | ||
==Laboratory findings== | ==Laboratory findings== | ||
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=== Full blood count: === | === Full blood count: === | ||
* Decreased [[platelet|platelets]] | * Decreased [[platelet|platelets]] | ||
=== Peripheral smear === | === Peripheral smear === | ||
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=== Clotting factors === | === Clotting factors === | ||
* [[prothrombin|Normal prothrombin]] time and [[partial thromboplastin time]] in up to 50% of patients (due to higher circulating levels of clotting factors such as [[factor Xa]] and [[thrombin]])<ref name="pmid20614398">{{cite journal |vauthors=Favaloro EJ |title=Laboratory testing in disseminated intravascular coagulation |journal=Semin. Thromb. Hemost. |volume=36 |issue=4 |pages=458–67 |date=June 2010 |pmid=20614398 |doi=10.1055/s-0030-1254055 |url=}}</ref> | * Elevated [[prothrombin time]] and [[partial thromboplastin time]] | ||
* [[prothrombin|Normal prothrombin]] time and [[partial thromboplastin time]] can be seen in up to 50% of patients (due to higher circulating levels of clotting factors such as [[factor Xa]] and [[thrombin]])<ref name="pmid20614398">{{cite journal |vauthors=Favaloro EJ |title=Laboratory testing in disseminated intravascular coagulation |journal=Semin. Thromb. Hemost. |volume=36 |issue=4 |pages=458–67 |date=June 2010 |pmid=20614398 |doi=10.1055/s-0030-1254055 |url=}}</ref> | |||
* Elevated [[fibrin]] and [[fibrinogen]] degradation products | * Elevated [[fibrin]] and [[fibrinogen]] degradation products | ||
* [[D-dimer]] more sensitive and specific for DIC | * Elevated [[D-dimer]] which is more sensitive and specific for DIC<ref name="pmid20950905">{{cite journal |vauthors=Levi M, Meijers JC |title=DIC: which laboratory tests are most useful |journal=Blood Rev. |volume=25 |issue=1 |pages=33–7 |date=January 2011 |pmid=20950905 |doi=10.1016/j.blre.2010.09.002 |url=}}</ref> | ||
* [[ | * Reduced [[antithrombin]] levels, which have become a key test for diagnosing and monitoring therapy in [[DIC]] | ||
* | * Increased [[bleeding time]] | ||
* Decreased [[fibrinogen]] level | |||
==References== | ==References== | ||
Latest revision as of 02:48, 24 December 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Omer Kamal, M.D.[2]
Overview
Laboratory findings consistent with the diagnosis of DIC include decreased platelets, increased fibrin degradation products, increased D-dimer, increased bleeding time, and decreased fibrinogen levels. Peripheral smear shows schistocytes and RBC fragments in ~ 50%, mild reticulocytosis, leukocytosis, and thrombocytopenia with an increased population of young platelets (due to increased destruction and turnover). Clotting factors include normal prothrombin time and partial thromboplastin time in up to 50% of patients (due to higher circulating levels of clotting factors such as factor Xa and thrombin), elevated fibrin and fibrinogen degradation products. D-dimer more sensitive and specific for DIC. Antithrombin levels have become a key test for diagnosing and monitoring therapy in DIC.
Laboratory findings
Laboratory findings consistent with the diagnosis of DIC include:[1]
Full blood count:
- Decreased platelets
Peripheral smear
- Schistocytes and RBC fragments in ~ 50%
- Mild reticulocytosis
- Leukocytosis
- Thrombocytopenia with an increased population of young platelets (due to increased destruction and turnover)
Clotting factors
- Elevated prothrombin time and partial thromboplastin time
- Normal prothrombin time and partial thromboplastin time can be seen in up to 50% of patients (due to higher circulating levels of clotting factors such as factor Xa and thrombin)[2]
- Elevated fibrin and fibrinogen degradation products
- Elevated D-dimer which is more sensitive and specific for DIC[3]
- Reduced antithrombin levels, which have become a key test for diagnosing and monitoring therapy in DIC
- Increased bleeding time
- Decreased fibrinogen level
References
- ↑ Venugopal A (September 2014). "Disseminated intravascular coagulation". Indian J Anaesth. 58 (5): 603–8. doi:10.4103/0019-5049.144666. PMC 4260307. PMID 25535423.
- ↑ Favaloro EJ (June 2010). "Laboratory testing in disseminated intravascular coagulation". Semin. Thromb. Hemost. 36 (4): 458–67. doi:10.1055/s-0030-1254055. PMID 20614398.
- ↑ Levi M, Meijers JC (January 2011). "DIC: which laboratory tests are most useful". Blood Rev. 25 (1): 33–7. doi:10.1016/j.blre.2010.09.002. PMID 20950905.