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   MeshID        = D004211 |
   MeshID        = D004211 |
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{{CMG}} {{AE}} {{OK}}
{{CMG}}; {{AE}} {{OK}}, {{MKA}}, {{S.G.}}


{{SK}} Disseminated intravascular coagulation, Disseminated intravascular coagulopathy, Consumptive coagulopathy, DIC
{{SK}} Disseminated intravascular coagulation, Disseminated intravascular coagulopathy, Consumptive coagulopathy, DIC
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== [[Disseminated intravascular coagulation classification|Classification]]==
== [[Disseminated intravascular coagulation classification|Classification]]==
[[Disseminated intravascular coagulation]] may be classified according to the degree of fibrinolytic activation into suppressed-fibrinolytic-type DIC (DIC with suppressed fibrinolysis), enhanced-fibrinolytic-type DIC (DIC with enhanced [[fibrinolysis]]) and balanced-fibrinolytic-type DIC (DIC with balanced [[fibrinolysis]]). Each type differs in clinical features and laboratory findings.
== [[Disseminated intravascular coagulation pathophysiology|Pathophysiology]] ==
== [[Disseminated intravascular coagulation pathophysiology|Pathophysiology]] ==
DIC is a hemorrhagic syndrome originating in the small blood vessels. DIC is caused by uncontrolled activation of clotting factors and fibrinolytic enzymes. Tissue necrosis and bleeding are results of DIC. Under [[Homeostasis|homeostatic]] conditions, the body is maintained in a finely tuned balance of [[coagulation]] and [[fibrinolysis]]. The activation of the [[coagulation]] cascade yields [[thrombin]] that converts [[fibrinogen]] to [[fibrin]]; the stable [[fibrin]] clot being the final product of [[hemostasis]]. The fibrinolytic system then functions to break down [[fibrinogen]] and fibrin. Activation of the [[Fibrinolysis|fibrinolytic]] system generates [[plasmin]] (in the presence of [[thrombin]]), which is responsible for the lysis of [[fibrin]] clots. The breakdown of [[fibrinogen]] and fibrin results in [[polypeptides]] called [[fibrin degradation products]] (FDPs) or [[fibrin split products]] (FSPs). In a state of [[homeostasis]], the presence of [[thrombin]] is critical, as it is the central [[proteolytic]] [[enzyme]] of coagulation and is also necessary for the breakdown of clots, or [[fibrinolysis]].
== [[Disseminated intravascular coagulation causes|Causes]] ==
== [[Disseminated intravascular coagulation causes|Causes]] ==
There are a variety of causes of [[DIC]], all usually causing the release of [[chemicals]] into the [[blood]] that instigates the [[coagulation]]. Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. [[Disseminated intravascular coagulation]] in itself is a life-threatening condition and must be treated as such irrespective of the cause. Common causes include [[abruptio placentae]], [[amniotic fluid embolism]], [[aortic aneurysm]], [[blood transfusion]] reaction, drugs (e.g. [[Amphetamines]]), beractant [[eclampsia]], giant [[hemangioma]], [[graft-versus-host disease]], [[HELLP syndrome]] and hemolytic transfusion reaction.
== [[Disseminated intravascular coagulation differential diagnosis|Differentiating Disseminated intravascular coagulation from other Diseases]] ==
== [[Disseminated intravascular coagulation differential diagnosis|Differentiating Disseminated intravascular coagulation from other Diseases]] ==
Disseminated intravascular coagulation (DIC) must be differentiated from other diseases that cause symptoms of [[DVT]] and [[pulmonary embolism]] such as: [[factor V Leiden mutation]], [[protein C deficiency]], [[protein S deficiency]], [[Prothrombin gene mutation G20210A|prothrombin gene mutation]], [[antithrombin III deficiency]], [[antiphospholipid antibody syndrome]].
== [[Disseminated intravascular coagulation epidemiology and demographics|Epidemiology and Demographics]] ==
== [[Disseminated intravascular coagulation epidemiology and demographics|Epidemiology and Demographics]] ==
The incidence of [[DIC]] is different in different [[diseases]] as it is almost always related to a life threatening condition. It depends on the cause of DIC such as cancer, infection, trauma and Obstetrical complications. The incidence of [[DIC]] is different in different [[diseases]] as it is almost always related to a life threatening condition. It depends on the cause of DIC such as [[cancer]], [[infection]], [[trauma]] and [[obstetrical]] complications. The [[prevalence]] of [[DIC]] depends on the clinical settings, higher versus low acquity settings. The data sometimes may underestimate the incidence of trasient or mild cases of DIC.
== [[Disseminated intravascular coagulation risk factors|Risk Factors]] ==
== [[Disseminated intravascular coagulation risk factors|Risk Factors]] ==
Common risk factors in the development of [[DIC]] include [[trauma]], [[sepsis]], [[obstetric]] complications, [[cancers]], and [[Immunological|immunologic]] reactions
== [[Disseminated intravascular coagulation screening|Screening]] ==
== [[Disseminated intravascular coagulation screening|Screening]] ==
There is insufficient evidence to recommend routine screening for DIC as it does not suggest any changes in mortality except in [[sepsis]]
== [[Disseminated intravascular coagulation natural history, complications and prognosis|Natural History, Complications and Prognosis]] ==
== [[Disseminated intravascular coagulation natural history, complications and prognosis|Natural History, Complications and Prognosis]] ==
If left untreated, 40-80% patients with DIC may progress to develop organ dysfunction. Common complications of DIC include [[renal failure]], [[hepatic dysfunction]], [[acute lung injury]], neurologic dysfunction and [[adrenal failure]]. Low levels of [[antithrombin]] at the onset if shock may predict an unfavorable [[prognosis]].
== Diagnosis ==
== Diagnosis ==


Latest revision as of 18:06, 20 September 2018
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Disseminated intravascular coagulation or Disseminated intravascular coagulopathy
ICD-10 D65
ICD-9 286.6
DiseasesDB 3765
MedlinePlus 000573
MeSH D004211

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omer Kamal, M.D.[2], M. Khurram Afzal, MD [3], Sogand Goudarzi, MD [4]

Synonyms and keywords: Disseminated intravascular coagulation, Disseminated intravascular coagulopathy, Consumptive coagulopathy, DIC

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Disseminated intravascular coagulation from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X Ray | Echocardiograph and Ultrasound | CT | MRI | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

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