Disseminated intravascular coagulation causes: Difference between revisions

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==Overview==
==Overview==
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.
==Causes==
==Causes==
There are a variety of causes of DIC<ref>{{cite book |last = Ledingham | first = J | coauthors = D Warrell | title = Concise Oxford Textbook of Medicine | publisher = Oxford University Press | date = 2000 | isbn = 0-19-262870-4,}}</ref>, all usually causing the release of chemicals into the blood that instigates the coagulation.
===Life Threatening Causes===
* Infections:
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.<ref name="pmid6773170">{{cite journal |vauthors=Spero JA, Lewis JH, Hasiba U |title=Disseminated intravascular coagulation. Findings in 346 patients |journal=Thromb. Haemost. |volume=43 |issue=1 |pages=28–33 |date=February 1980 |pmid=6773170 |doi= |url=}}</ref>
** [[Sepsis]], particularly with [[gram-negative bacteria]]
 
** Viral
Disseminated intravascular coagulation in itself is a life-threatening condition and must be treated as such irrespective of the cause.<ref name="pmid19222477">{{cite journal |vauthors=Levi M, Toh CH, Thachil J, Watson HG |title=Guidelines for the diagnosis and management of disseminated intravascular coagulation. British Committee for Standards in Haematology |journal=Br. J. Haematol. |volume=145 |issue=1 |pages=24–33 |date=April 2009 |pmid=19222477 |doi=10.1111/j.1365-2141.2009.07600.x |url=}}</ref><ref name="pmid18066597">{{cite journal |vauthors=Ghosh K, Shetty S |title=Blood coagulation in falciparum malaria--a review |journal=Parasitol. Res. |volume=102 |issue=4 |pages=571–6 |date=March 2008 |pmid=18066597 |doi=10.1007/s00436-007-0832-0 |url=}}</ref><ref name="pmid580488">{{cite journal |vauthors=Siegal T, Seligsohn U, Aghai E, Modan M |title=Clinical and laboratory aspects of disseminated intravascular coagulation (DIC): a study of 118 cases |journal=Thromb. Haemost. |volume=39 |issue=1 |pages=122–34 |date=February 1978 |pmid=580488 |doi= |url=}}</ref>
** [[Malaria]]
 
** [[Rickettsial]]
===Common Causes===
* Obstetric complications (most common cause), with chemicals from the [[uterus]] being released into the blood. These include:
*[[Abruptio placentae]]
** [[Amniotic fluid embolism]]
*[[Amniotic fluid embolism]]
** [[Eclampsia]]
*[[Aortic aneurysm]]
** ''[[Abruptio placentae]]''
*[[transfusion reaction|Blood transfusion reaction]]
** [[Placenta praevia]]
*[[Drugs]] (e.g. [[Amphetamines]]), [[Beractant]]
** intra-uterine death
*[[Eclampsia]]
* Tissue trauma such as burns, accidents, surgery, heat stroke or [[Shock (medical)|shock]].
*[[hemangioma|Giant hemangioma]]
* [[Liver]] disease:
*[[Graft-versus-host disease]]
** [[Cirrhosis]]
*[[HELLP syndrome]]
** Acute hepatic [[necrosis]]
*[[transfusion reaction|Hemolytic transfusion reaction]]
* Incompatible blood [[transfusion reaction]]s or massive [[blood transfusion]] (when more than the total circulatory volume is tranfused)
*[[Liver disease]]
* [[Graft-versus-host disease]]
*[[Malignancy]] (especially [[APL]])
* Cancers, particularly of the following types, and especially when [[metastatic]]:
*[[Sepsis]] (esp. [[gram-negative bacteria]])
** [[Stomach cancer]]
*[[allergy|Severe allergic reaction]]
** [[Colorectal cancer]]
*[[Transplant rejection]]
** [[Pancreatic cancer]]
*[[Trauma]] (e.g. [[Fat embolism]], [[head injury]])
** [[Mucin]]-secreting [[adenocarcinoma]]
*[[Venomous snake]]
** [[acute promyelocytic leukemia]]
*[[Viral hemorrhagic fever]]
* [[Viral hemorrhagic fever]]s bring about their frank effects, paradoxically, by causing DIC.
 
* Envenomation by some [[species]] of [[venomous snake]]s, such as those belonging to the [[genus]] ''[[Echis]]'' (saw-scaled vipers).
===Causes by Organ System===
 
{| style="width:80%; height:100px" border="1"
| style="width:25%" bgcolor="LightSteelBlue" ; border="1" | '''Cardiovascular'''
| style="width:75%" bgcolor="Beige" ; border="1" | [[Aortic aneurysm]], [[malignant hypertension]], [[myocardial infarction]], [[septic shock]], [[shock]], [[vasculitis]]
|-
|- bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
| bgcolor="Beige" | [[snake bite|Snake bite (elapid)]]
|-
|- bgcolor="LightSteelBlue"
| '''Dermatologic'''
| bgcolor="Beige" | [[Purpura fulminans]], [[Raynaud's disease]], [[rheumatoid arthritis]], [[vasculitis]]
|-
|- bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| bgcolor="Beige" | [[Amphetamine]], [[cocaine]], [[indomethacin]], [[interleukin 2]], [[Mafenide]], [[serotonin syndrome]], [[Dinoprostone]]
|-
|- bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Endocrine'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Environmental'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| bgcolor="Beige" | [[Acute fatty liver of pregnancy]], [[hepatic failure|acute hepatic failure]], [[acute pancreatitis]], [[Crohn disease]], [[hepatic failure|fulminant hepatic failure]], [[liver disease]], [[ulcerative colitis]]
|-
|- bgcolor="LightSteelBlue"
| '''Genetic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Hematologic'''
| bgcolor="Beige" | [[transfusion reaction|Acute hemolytic transfusion reactions]], [[acute myeloid leukemia]], [[acute promyelocytic leukemia]],  [[antiphospholipid syndrome]], [[Kasabach-Merritt syndrome]], [[myeloproliferative syndrome]], [[paroxysmal nocturnal hemoglobinuria]], [[purpura fulminans]], [[Trousseau's syndrome]]
|-
|- bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| bgcolor="Beige" | [[transplant rejection|Acute renal allograft rejection]], [[Denver shunt]], [[surgery|extensive surgery]], [[LeVeen shunt]], [[liver transplantation]],  [[peritoneovenous shunt]], [[prosthetic devices]], [[serotonin syndrome]], [[surgery]], [[anesthesia|recent anesthesia]], [[ventricular assist devices]]
|-
|- bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| bgcolor="Beige" | [[arenavirus|Arenaviruses]], [[Argentine hemorrhagic fever]], [[aspergillosis]], [[hemorrhagic fever|Bolivian hemorrhagic fever]], [[capnocytophaga canimorsus]], [[CMV]], [[HELLP syndrome]], [[hepatitis|hepatitis viruses]], [[histoplasmosis]], [[malaria|malaria (malignant tertian)]], [[meningococcemia|meningococcal septicaemia]], [[mycoplasma pneumoniae]], [[neisseria meningiditis]], [[osteomyelitis]], [[rocky mountain spotted fever]], [[sarcoidosis]], [[sepsis]], [[septic shock]], [[African trypanosomiasis|sleeping sickness (East African)]], [[streptococcus pneumoniae]], [[tuberculosis]], [[typhoid fever]], [[hemorrhagic fever|viral hemorrhagic fevers]], [[VZV]]
|-
|- bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
| bgcolor="Beige" | [[Osteomyelitis]]
|-
|- bgcolor="LightSteelBlue"
| '''Neurologic'''
| bgcolor="Beige" | [[Antiphospholipid syndrome]], [[meningococcemia|meningococcal septicaemia]], [[neisseria meningiditis]]
|-
|- bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
| bgcolor="Beige" | [[Abruptio placentae]], [[amniotic fluid embolism]], [[dead fetus syndrome]], [[eclampsia]], [[HELLP syndrome]], [[intrauterine death]], [[pre-eclampsia]], [[retained intrauterine fetal demise]], [[septic abortion]]
|-
|- bgcolor="LightSteelBlue"
| '''Oncologic'''
| bgcolor="Beige" | [[Acute myeloid leukemia]], [[acute promyelocytic leukemia]], [[carcinoma|Cancers of lung, pancreas, prostate and stomach]], [[hemangioma|giant hemangioma]], [[Kasabach-Merritt syndrome]], [[malignancy]], [[mucin|mucin-secreting adenocarcinoma]], [[paraneoplastic syndrome]], [[Trousseau's syndrome]]
|-
|- bgcolor="LightSteelBlue"
| '''Opthalmologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
| bgcolor="Beige" | [[Amphetamine]], [[cocaine]]
|-
|- bgcolor="LightSteelBlue"
| '''Psychiatric'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Pulmonary'''
| bgcolor="Beige" | [[Acute respiratory distress syndrome]], [[empyema]], [[mycoplasma pneumoniae]], [[sarcoidosis]], [[streptococcus pneumoniae]], [[tuberculosis]]
|-
|- bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
| bgcolor="Beige" | [[Renal failure]]
|-
|- bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
| bgcolor="Beige" | [[transplant rejection|Acute  renal allograft rejection]], [[antiphospholipid  syndrome]], [[interleukin 2]], [[macrophage-activation  syndrome]], [[paraneoplastic  syndrome]], [[Raynaud's disease]], [[rheumatoid arthritis]], [[sarcoidosis]], [[vasculitis]]
|-
|- bgcolor="LightSteelBlue"
| '''Sexual'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Trauma'''
| bgcolor="Beige" | [[Burns]], [[crush syndrome]], [[head injury]], [[electrical injury|lightning strike]], [[motor vehicle accidents]], [[soft tissue injury|severe tissue injury]], [[trauma]]
|-
|- bgcolor="LightSteelBlue"
| '''Urologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Dental'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| bgcolor="Beige" | [[Heat  stroke]], [[hyperthermia]], [[prosthetic devices]], [[snake bite|Snake bite (elapid)]], [[venomous snake|venomous snakes]]
|-
|}
 
===Causes in Alphabetical Order===
{{col-begin|width=80%}}
{{col-break|width=33%}}
*[[Abruptio placentae]]<ref name="pmid10763841">{{cite journal| author=Lurie S, Feinstein M, Mamet Y| title=Disseminated intravascular coagulopathy in pregnancy: thorough comprehension of etiology and management reduces obstetricians' stress. | journal=Arch Gynecol Obstet | year= 2000 | volume= 263 | issue= 3 | pages= 126-30 | pmid=10763841 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10763841  }} </ref>
*[[Acute fatty liver of pregnancy]]
*[[transfusion reaction|Acute hemolytic transfusion reactions]]
*[[hepatic failure|Acute hepatic failure]]
*[[Acute myeloid leukemia]]
*[[Acute pancreatitis]]
*[[Acute promyelocytic leukemia]]
*[[transplant rejection|Acute renal allograft rejection]]
*[[Acute respiratory distress syndrome]]
*[[Amniotic fluid embolism]]<ref name="pmid10763841">{{cite journal| author=Lurie S, Feinstein M, Mamet Y| title=Disseminated intravascular coagulopathy in pregnancy: thorough comprehension of etiology and management reduces obstetricians' stress. | journal=Arch Gynecol Obstet | year= 2000 | volume= 263 | issue= 3 | pages= 126-30 | pmid=10763841 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10763841  }} </ref>
*[[Amphetamine]]
*[[Antiphospholipid syndrome]]
*[[Aortic aneurysm]]
*[[Arenavirus]]es
*[[hemorrhagic fever|Argentine hemorrhagic fever]]  
*[[Aspergillosis]]
*[[hemorrhagic fever|Bolivian hemorrhagic fever]]
*[[Burns]]
*[[Capnocytophaga canimorsus]]  
*[[carcinoma|Carcinoma (eg lung, pancreas, prostate and stomach)]]
*[[CMV]]
*[[Cocaine]]
*[[Crohn disease]]  
*[[Crush syndrome]]
*[[Dead fetus syndrome]]
*[[peritoneovenous shunt|Denver shunt]]
*[[Eclampsia]]
*[[Empyema]]
*[[surgery|Extensive surgery]]
*[[Fulminant hepatic failure]]
*[[hemangioma|Giant hemangioma]]
*[[Head injury]]
*[[Heat stroke]]
*[[HELLP syndrome]]<ref name="pmid10763841">{{cite journal| author=Lurie S, Feinstein M, Mamet Y| title=Disseminated intravascular coagulopathy in pregnancy: thorough comprehension of etiology and management reduces obstetricians' stress. | journal=Arch Gynecol Obstet | year= 2000 | volume= 263 | issue= 3 | pages= 126-30 | pmid=10763841 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10763841  }} </ref>
*[[hepatitis|Hepatitis viruses]]
*[[Histoplasmosis]]
*[[Hyperthermia]]
*[[Interleukin 2]]
*[[Intrauterine death]]
*[[Kasabach-Merritt syndrome]]
*[[peritoneovenous shunt|LeVeen shunt]]
*[[electrical injury|Lightning strike]]
*[[Liver disease]]
*[[Liver transplantation]]  
*[[Macrophage-activation syndrome]]
{{col-break|width=33%}}
*[[malaria|Malaria (malignant tertian)]]
*[[Malignancy]]
*[[Malignant hypertension]]
*[[meningococcemia|Meningococcal septicaemia]]
*[[Motor vehicle accidents]]
*[[mucin|Mucin-secreting adenocarcinoma]]
*[[Mycoplasma pneumoniae]]
*[[Myeloproliferative syndrome]]
*[[Myocardial infarction]]
*[[Neisseria meningiditis]]
*[[Osteomyelitis]]
*[[Paraneoplastic syndrome]]
*[[Paroxysmal nocturnal hemoglobinuria]]
*[[Peritoneovenous shunt]]
*[[Pre-eclampsia]] <ref name="pmid10763841">{{cite journal| author=Lurie S, Feinstein M, Mamet Y| title=Disseminated intravascular coagulopathy in pregnancy: thorough comprehension of etiology and management reduces obstetricians' stress. | journal=Arch Gynecol Obstet | year= 2000 | volume= 263 | issue= 3 | pages= 126-30 | pmid=10763841 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10763841  }} </ref>
*[[Prosthetic devices]]
*[[Purpura fulminans]]  
*[[Raynaud's disease]]
*[[anesthesia|Recent anesthesia]]
*[[Renal failure]]
*[[stillbirth|Retained intrauterine fetal demise]]<ref name="pmid10763841">{{cite journal| author=Lurie S, Feinstein M, Mamet Y| title=Disseminated intravascular coagulopathy in pregnancy: thorough comprehension of etiology and management reduces obstetricians' stress. | journal=Arch Gynecol Obstet | year= 2000 | volume= 263 | issue= 3 | pages= 126-30 | pmid=10763841 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10763841  }} </ref>
*[[Rheumatoid arthritis]]
*[[Rocky mountain spotted fever]]
*[[Sarcoidosis]]
*[[Sepsis]]
*[[Septic abortion]]
*[[Septic shock]]
*[[Serotonin syndrome]]
*[[soft tissue injury|Severe tissue injury]]
*[[Shock]]
*[[african trypanosomiasis|Sleeping sickness (East african)]]
*[[snake bite|Snake bite (Elapid)]]
*[[Streptococcus pneumoniae]]
*[[Surgery]]
*[[Trauma]]
*[[Trousseau's syndrome]]
*[[Tuberculosis]]
*[[Typhoid fever]]
*[[Ulcerative colitis]]
*[[Vasculitis]]
*[[Venomous snake]]
*[[Ventricular assist devices]]
*[[hemorrhagic fever|Viral hemorrhagic fevers]]
*[[VZV]]
{{col-end}}
 
==References==
{{reflist|2}}
 
[[Category:Hematology]]
[[Category:Cardiology]]
 
 
{{WS}}
{{WH}}

Latest revision as of 14:25, 30 August 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2] Omer Kamal, M.D.[3]

Overview

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.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.[1]

Disseminated intravascular coagulation in itself is a life-threatening condition and must be treated as such irrespective of the cause.[2][3][4]

Common Causes

Causes by Organ System

Cardiovascular Aortic aneurysm, malignant hypertension, myocardial infarction, septic shock, shock, vasculitis
Chemical / poisoning Snake bite (elapid)
Dermatologic Purpura fulminans, Raynaud's disease, rheumatoid arthritis, vasculitis
Drug Side Effect Amphetamine, cocaine, indomethacin, interleukin 2, Mafenide, serotonin syndrome, Dinoprostone
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic Acute fatty liver of pregnancy, acute hepatic failure, acute pancreatitis, Crohn disease, fulminant hepatic failure, liver disease, ulcerative colitis
Genetic No underlying causes
Hematologic Acute hemolytic transfusion reactions, acute myeloid leukemia, acute promyelocytic leukemia, antiphospholipid syndrome, Kasabach-Merritt syndrome, myeloproliferative syndrome, paroxysmal nocturnal hemoglobinuria, purpura fulminans, Trousseau's syndrome
Iatrogenic Acute renal allograft rejection, Denver shunt, extensive surgery, LeVeen shunt, liver transplantation, peritoneovenous shunt, prosthetic devices, serotonin syndrome, surgery, recent anesthesia, ventricular assist devices
Infectious Disease Arenaviruses, Argentine hemorrhagic fever, aspergillosis, Bolivian hemorrhagic fever, capnocytophaga canimorsus, CMV, HELLP syndrome, hepatitis viruses, histoplasmosis, malaria (malignant tertian), meningococcal septicaemia, mycoplasma pneumoniae, neisseria meningiditis, osteomyelitis, rocky mountain spotted fever, sarcoidosis, sepsis, septic shock, sleeping sickness (East African), streptococcus pneumoniae, tuberculosis, typhoid fever, viral hemorrhagic fevers, VZV
Musculoskeletal / Ortho Osteomyelitis
Neurologic Antiphospholipid syndrome, meningococcal septicaemia, neisseria meningiditis
Nutritional / Metabolic No underlying causes
Obstetric/Gynecologic Abruptio placentae, amniotic fluid embolism, dead fetus syndrome, eclampsia, HELLP syndrome, intrauterine death, pre-eclampsia, retained intrauterine fetal demise, septic abortion
Oncologic Acute myeloid leukemia, acute promyelocytic leukemia, Cancers of lung, pancreas, prostate and stomach, giant hemangioma, Kasabach-Merritt syndrome, malignancy, mucin-secreting adenocarcinoma, paraneoplastic syndrome, Trousseau's syndrome
Opthalmologic No underlying causes
Overdose / Toxicity Amphetamine, cocaine
Psychiatric No underlying causes
Pulmonary Acute respiratory distress syndrome, empyema, mycoplasma pneumoniae, sarcoidosis, streptococcus pneumoniae, tuberculosis
Renal / Electrolyte Renal failure
Rheum / Immune / Allergy Acute renal allograft rejection, antiphospholipid syndrome, interleukin 2, macrophage-activation syndrome, paraneoplastic syndrome, Raynaud's disease, rheumatoid arthritis, sarcoidosis, vasculitis
Sexual No underlying causes
Trauma Burns, crush syndrome, head injury, lightning strike, motor vehicle accidents, severe tissue injury, trauma
Urologic No underlying causes
Dental No underlying causes
Miscellaneous Heat stroke, hyperthermia, prosthetic devices, Snake bite (elapid), venomous snakes

Causes in Alphabetical Order

References

  1. ↑ Spero JA, Lewis JH, Hasiba U (February 1980). "Disseminated intravascular coagulation. Findings in 346 patients". Thromb. Haemost. 43 (1): 28–33. PMID 6773170.
  2. ↑ Levi M, Toh CH, Thachil J, Watson HG (April 2009). "Guidelines for the diagnosis and management of disseminated intravascular coagulation. British Committee for Standards in Haematology". Br. J. Haematol. 145 (1): 24–33. doi:10.1111/j.1365-2141.2009.07600.x. PMID 19222477.
  3. ↑ Ghosh K, Shetty S (March 2008). "Blood coagulation in falciparum malaria--a review". Parasitol. Res. 102 (4): 571–6. doi:10.1007/s00436-007-0832-0. PMID 18066597.
  4. ↑ Siegal T, Seligsohn U, Aghai E, Modan M (February 1978). "Clinical and laboratory aspects of disseminated intravascular coagulation (DIC): a study of 118 cases". Thromb. Haemost. 39 (1): 122–34. PMID 580488.
  5. ↑ 5.0 5.1 5.2 5.3 5.4 Lurie S, Feinstein M, Mamet Y (2000). "Disseminated intravascular coagulopathy in pregnancy: thorough comprehension of etiology and management reduces obstetricians' stress". Arch Gynecol Obstet. 263 (3): 126–30. PMID 10763841.


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