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Disseminated Intravascular Coagulation (DIC)


Intravascular consumption of platelets and plasma clotting factors.

  • Uncontrolled activation of coagulation and fibrinolysis
  • Consumption of clotting factors and platelets

There is widespread coagulation within blood vessels leading to the deposition of fibrin thrombi and hemorrhage when all the clotting factors and platelets have been used up.

The accumulation of fibrin in the tiny blood vessels leads to mechanical damage to red blood cells and a "microangiopathic hemolytic anemia".

Presents with :

  • Bruising and bleeding
  • can lead to shock, intracranial bleeding, death


Below is a typical purpuric rash associated with DIC:


DIC occurs in patients with severe illnesses

Classically occurs in subtypes of AML especially AML M3 (Acute promyelocytic leukemia)


Diseases associated with DIC:

Tissue Injury Trauma/Crush injuries. Head Injury. Major surgery

Endothelial cell Injury

&/ Abnormal Vascular surfaces


(bacterial, viral or protozoal)


Giant Hemangioma
Cardiopulmonary bypass

Platelet or leukocyte or red cell injury

Incompatible blood transfusions
Allograft rejection
Drug hypersensitivity
Hemolytic syndromes


Laboratory Results

  • ↓ platelets
  • ↑ PT, PTT
  • ↓ fibrinogen
  • ↑ FDP’s
  • ↓ clotting factors



  • Treat the underlying cause
  • Fresh Frozen Plasma / Cryoprecipitate / platelets
  • Packed Red Blood Cells
  • Heparin  → - controversial, - switches off thrombin production  - ??only recommended when aggressive replacement therapy fails to correct a dangerous coagulopathy



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