Disseminated intravascular coagulation (DIC)

Blood clot formation

Blood clotting normally occurs when there is damage to a blood vessel. Platelets immediately begin to adhere to the cut edges of the vessel and release chemicals to attract even more platelets. A platelet plug is formed, and the external bleeding stops.Next, small molecules, called clotting factors, cause strands of blood-borne materials, called fibrin, to stick together and seal the inside of the wound. Eventually, the cut blood vessel heals and the blood clot dissolves after a few days.

Also known as: Consumption coagulopathy

Definition

Disseminated intravascular coagulation (DIC) is a serious disorder in which the proteins that control blood clotting become abnormally active.

Causes, incidence, and risk factors

Normally when you are injured, certain proteins in the blood become activated and travel to the injury site to help stop bleeding. However, in persons with DIC, these proteins become abnormally active. This often occurs due to inflammation, infection, or cancer.

Small blood clots form in the blood vessels. Some of these clots can clog up the vessels and cut off blood supply to various organs such as the liver, brain, or kidney. These organs will then be damaged and may stop functioning.

Over time, the clotting proteins are consumed or "used up." When this happens, the person is then at risk for serious bleeding, even from a minor injury or without injury. This process may also break up healthy red blood cells.

Risk factors for DIC include:

  • Blood transfusion reaction
  • Cancer, especially certain types of leukemia
  • Infection in the blood by bacteria or fungus
  • Liver disease
  • Pregnancy complications (such as placenta that is left behind after delivery)
  • Recent surgery or anesthesia
  • Sepsis (a serious infection)
  • Severe tissue injury (as in burns and head injury)

Symptoms

  • Bleeding, possibly from multiple sites in the body
  • Blood clots
  • Bruising
  • Drop in blood pressure

Signs and tests

The following tests may be done:

Treatment

The goal is to determine and treat the cause of DIC.

Blood clotting factors may be replaced with plasma transfusions. Platelet transfusions can raise the blood count. Heparin, a medication used to prevent clotting, is sometimes used to interrupt clotting events.

Expectations (prognosis)

The outcome depends on what is causing the disorder, but DIC can be life-threatening.

Complications

  • Bleeding
  • Lack of blood flow to the arms, legs, or vital organs
  • Stroke

Calling your health care provider

Go to the emergency room or call 911 if you have bleeding that won't stop.

Prevention

Get prompt treatment for conditions known to bring on this disorder.

References

Schafer AI. Hemorrhagic disorders: disseminated intravascular coagulation, liver failure, and vitamin K deficiency. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 181.

Liebman HA, Weitz IC. Disseminated intravascular coagulation. In: Hoffman R, Benz EJ, Shattil SS, et al., eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 132.

See also:

  • Disease

    Sepsis

    Antibodies

    Sepsis is a severe illness in which the bloodstream is overwhelmed by bacteria.

  • Disease

    Transfusion reaction - hemolytic

    Surface proteins causing rejection

    A hemolytic transfusion reaction is a serious problem that occurs after a patient receives a transfusion of blood. The red blood cells that were given to the patient are destroyed by the patient’s own immune system.

  • Disease

    Liver disease

    Liver fattening, CT scan

    The term “liver disease” applies to many diseases and disorders that cause the liver to function improperly or stop functioning. Abdominal pain, yellowing of the skin or eyes (), or abnormal results of suggest you have liver disease. See also:

  • Disease

    Blood clots

    Thrombus

    Blood clots are clumps that occur when blood hardens from a liquid to a solid. A blood clot that forms inside a blood vessel or within the heart and stays there is called a thrombus. A thrombus that breaks loose and travels from one location in the body to another is called an embolus. The ...

  • Disease

    Mesenteric venous thrombosis

    Mesenteric venous thrombosis is a in one or more of the major veins that drain blood from the intestine.

Review date:
December 28, 2010
Reviewed by:
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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