Disseminated intravascular coagulation

Disseminated intravascular coagulation (DIC), also known as consumption coagulopathy and defibrination syndrome, refers to a systemic phenomenon of overactivation of coagulation and fibrinolysis resulting in widespread clots forming inside blood vessels.

Patients present with bleeding and/or thrombosis, as well as subsequent organ damage.

During homeostasis, there is a balance between coagulation (formation of clots) and fibrinolysis (breakdown of clots). 

During times of stress listed under "Etiology", this homeostasis is disrupted resulting in dysregulated coagulation and fibrinolysis. Widespread clotting occurs exhausting available clotting factors and platelets resulting in excess bleeding. An important mediator in this process is a transmembrane glycoprotein called tissue factor (TF)

The most common causes of DIC are:

  1. infection and sepsis
  2. malignancy, and
  3. trauma (including surgery) 1,2.

The diagnosis is supported by laboratory findings of coagulopathy and/or fibrinolysis including:

  • low platelets,
  • low fibrinogen,
  • elevated D-dimer,
  • prolonged prothrombin time (PT),
  • prolonged international normalized ratio (INR)
  • prolonged activated partial thromboplastin time (aPTT)
  • schistocytes on blood smear due to microangiopathic hemolytic anemia

Management focuses on treating the underlying condition. Supportive measures include helping the organs that are affected, such as:

  • ventilator support
  • hemodynamic support
  • transfusions (platelets or red blood cells)

DIC can lead to:

  • ischemia: insufficient blood flow (and subsequent lack of oxygen delivery) to tissue
  • infarction: tissue death (by necrosis) due to inadequate blood supply
  • damage to vital organs e.g. brain, lungs, liver, and kidneys 3
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Article information

rID: 64952
System: Haematology
Section: Pathology
Synonyms or Alternate Spellings:
  • Consumption coagulopathy and defibrination syndrome
  • DIC

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