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Disseminated intravascular coagulation (DIC) is a rare, life-threatening
condition that prevents a person's blood from clotting normally. It may cause
excessive clotting (thrombosis) or bleeding (hemorrhage) throughout the body
and lead to
shock, organ failure, and death.
the body's natural ability to regulate blood clotting does not function
properly. This causes the blood's clotting cells (platelets) to
clump together and clog small blood vessels throughout the body. This excessive
clotting damages organs, destroys blood cells, and depletes the supply of
platelets and other clotting factors so that the blood is no longer able to
clot normally. This often causes widespread bleeding, both internally and
DIC can be triggered by a health
problem that sets the clotting cascade in motion. Such health problems include:
In most cases, the condition causing the DIC will be
known (such as severe trauma). In rare cases, extensive bleeding caused by DIC
will be the first symptom of the disease or condition causing it (such as
When DIC causes the blood's
platelets and clotting factors to become depleted, excessive bleeding
(hemorrhage) occurs throughout the body. The severity of bleeding can range
from small red dots and bruises under the skin to heavy bleeding from surgical
wounds or body openings, such as the mouth, nose, rectum, or vagina.
Symptoms of organ damage caused by excessive blood clotting may include
shortness of breath from lung damage, low urine output from kidney damage, or
stroke from damage to the brain. In severe cases,
shock, with low blood pressure and widespread organ failure, may occur.
In a less severe type of DIC called chronic DIC, the body is able to
compensate for the abnormal clotting. Chronic DIC may produce no symptoms or
only mild blood clotting or minimal bleeding from the skin or mouth.
DIC is a very complex
condition that can be hard to diagnose. There is no single test that is used to
diagnose DIC. In some cases, several different tests given over a period of
time may be needed for an accurate diagnosis.
A doctor may suspect
DIC in a person who has symptoms of excessive bleeding or clotting. Blood tests
to measure the amount of platelets and other substances (such as prothrombin
and fibrinogen) that affect clotting can help confirm the diagnosis.
Tests that may be used to diagnose DIC include:
DIC depends on the medical condition that is causing
it. If that condition can be treated, the DIC may get better. People with acute
DIC require hospitalization, sometimes in an intensive care unit (ICU), where
treatment will attempt to correct the problem causing the DIC while maintaining
the function of the organs.
The U.S. National Heart, Lung, and Blood Institute
(NHLBI) information center offers information and publications about preventing
Other Works Consulted
Halfdanarson TR, et al. (2012). Emergencies in hematology and oncology. In EG Nabel, ed., ACP Medicine, section 8, chap. 5. Hamilton, ON: BC Decker.
Levi M, Seligsohn U (2010). Disseminated intravascular coagulation. In K Kaushanksy et al., eds., Williams Hematology, 8th ed., pp. 2101–2120. New York: McGraw-Hill.
Santen SA, Hemphill RR (2011). Acquired bleeding disorders. In JE Tintinalli, ed., Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7th ed., pp. 1464–1470. New York: McGraw-Hill.
December 14, 2012
E. Gregory Thompson, MD - Internal Medicine & Brian Leber, MDCM, FRCPC - Hematology
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