Disseminated intravascular coagulation classification
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Disseminated intravascular coagulation Microchapters |
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Differentiating Disseminated intravascular coagulation from other Diseases |
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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
There is no established system for the classification of [disease name].
OR
[Disease name] may be classified according to [classification method] into [number] subtypes/groups: [group1], [group2], [group3], and [group4].
OR
[Disease name] may be classified into [large number > 6] subtypes based on [classification method 1], [classification method 2], and [classification method 3]. [Disease name] may be classified into several subtypes based on [classification method 1], [classification method 2], and [classification method 3].
OR
Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.
OR
If the staging system involves specific and characteristic findings and features: According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].
OR
The staging of [malignancy name] is based on the [staging system].
OR
There is no established system for the staging of [malignancy name].
Classification
Disseminated intravascular coagulation may be classified according to the degree of fibrinolytic activation into the following subtypes/groups[1]:
Suppressed-fibrinolytic-type DIC (DIC with suppressed fibrinolysis) [2][3][4][5]
- Severe coagulation activation
- Mild fibrinolytic activation
- Seen in sepsis mostly
- Mild bleeding complications
- Elevated thrombin-antithrombin complex (TAT) , a coagulation activation marker
- Mildy elevated plasmin-α2 plasmin inhibitor complex (PIC), a fibrinolysis activation marker
- Mildly elevated Fibrin/fibrinogen degradation products (FDPs) and D-dimers
- Normal or only slightly decreased α2 plasmin inhibitor (α2PI)
Enhanced-fibrinolytic-type DIC (DIC with enhanced fibrinolysis)
Presents with marked fibrinolysis activation corresponding to coagulation activation
Strong activation of fibrinolysis
with hardly any elevation in PAI
Severe bleeding severe.
Elevation in both TAT and PIC
Elevated FDPs and D-dimer
FDP/D-dimer ratio tends to increase (decrease when expressed as the D-dimer/FDP ratio).
Associated with APL, abdominal aortic aneurysm, and prostate cancer.
Balanced-fibrinolytic-type DIC (DIC with balanced fibrinolysis)
DIC with a balance between coagulation activation and fibrinolytic activation, with an intermediate pathogenesis between the above-mentioned types, is called ‘balanced-fibrinolytic-type DIC.’ Bleeding symptoms and organ symptoms are relatively uncommon except in advanced cases. This type of DIC is common in solid cancers, but it may progress to DIC with enhanced fibrinolysis in some cancers, such as prostate cancer and vascular malignancies.
If the staging system involves specific and characteristic findings and features:
According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].
OR
The staging of [malignancy name] is based on the [staging system].
OR
There is no established system for the staging of [malignancy name].
References
- ↑ Asakura H (2014). "Classifying types of disseminated intravascular coagulation: clinical and animal models". J Intensive Care. 2 (1): 20. doi:10.1186/2052-0492-2-20. PMC 4267600. PMID 25520834.
- ↑ Asakura H, Ontachi Y, Mizutani T, Kato M, Saito M, Kumabashiri I, Morishita E, Yamazaki M, Aoshima K, Nakao S (June 2001). "An enhanced fibrinolysis prevents the development of multiple organ failure in disseminated intravascular coagulation in spite of much activation of blood coagulation". Crit. Care Med. 29 (6): 1164–8. PMID 11395595.
- ↑ Takahashi H, Tatewaki W, Wada K, Hanano M, Shibata A (February 1990). "Thrombin vs. plasmin generation in disseminated intravascular coagulation associated with various underlying disorders". Am. J. Hematol. 33 (2): 90–5. PMID 1689102.
- ↑ Asakura H, Jokaji H, Saito M, Uotani C, Kumabashiri I, Morishita E, Yamazaki M, Aoshima K, Matsuda T (October 1994). "Study of the balance between coagulation and fibrinolysis in disseminated intravascular coagulation using molecular markers". Blood Coagul. Fibrinolysis. 5 (5): 829–32. PMID 7865691.
- ↑ Asakura H, Jokaji H, Saito M, Uotani C, Kumabashiri I, Morishita E, Yamazaki M, Matsuda T (March 1991). "Changes in plasma levels of tissue-plasminogen activator/inhibitor complex and active plasminogen activator inhibitor in patients with disseminated intravascular coagulation". Am. J. Hematol. 36 (3): 176–83. PMID 1899963.