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Disseminated intravascular coagulation (DIC)

Definition

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

Alternative Names

Consumption coagulopathy; DIC

Causes

When you are injured, proteins in the blood that form blood clots travel to the injury site to help stop bleeding. If you have DIC, these proteins become abnormally active throughout the body. This may be due to inflammation, infection, or cancer.

Small blood clots form in the blood vessels. Some of these clots can clog the vessels and cut off blood supply to organs such as the liver, brain, or kidneys. Lack of blood flow can damage the organ and it may stop working properly.

Over time, the clotting proteins in your blood are consumed or "used up." When this happens, you have a high risk of serious bleeding, even from a minor injury or without injury. You may also have bleeding that starts spontaneously (on its own). The disease can also cause healthy red blood cells to break up when they travel through the small vessels that are filled with clots.

Risk factors for DIC include:

  • Blood transfusion reaction
  • Cancer, especially certain types of leukemia
  • Inflammation of the pancreas (pancreatitis)
  • Infection in the blood, especially by bacteria or fungus
  • Liver disease
  • Pregnancy complications (such as placenta that is left behind after delivery)
  • Recent surgery or anesthesia
  • Severe tissue injury (as in burns and head injury)
  • Large hemangioma (a blood vessel that is not formed properly)

Symptoms

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

Exams and Tests

You may have any of the following tests:

Treatment

There is no specific treatment for DIC. The goal is to determine and treat the underlying cause of DIC.

Supportive treatments may include:

  • Plasma transfusions to replace blood clotting factors if a large amount of bleeding is occurring
  • Blood thinner medicine (heparin) to prevent blood clotting if a large amount of clotting is occurring

Outlook (Prognosis)

Outcome depends on what is causing the disorder. DIC can be life-threatening.

Possible 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 does not stop.

Prevention

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

References

Levi M. Disseminated intravascular coagulation. In: Hoffman R, Benz EJ Jr, Silberstein LE, et al., eds. Hematology: Basic Principles and Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 141.

Thachil J, Toh CH. Current concepts in the management of disseminated intravascular coagulation. Thromb Res. 2012;129 Suppl 1:S54-S59. PMID: 22682134 www.ncbi.nlm.nih.gov/pubmed/22682134.

Review Date:10/30/2013
Reviewed By:Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

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