Disseminated Intravascular Coagulation (DIC)

Disseminated intravascular coagulation is most commonly seen as a complication of obstetric catastrophes, cancer, sepsis, or trauma.^1,2 Infection is it's most common cause.^1,2 It involves consumption of procoagulants and platelets and the generation of intravascular fibrin.^1,3 The subcommittee on DIC of the International Society on Thrombosis and Hemostasis has suggested the following definition for DIC: "An acquired syndrome characterized by the intravascular activation of coagulation with loss of localization arising from different causes. It can originate from and cause damage to the microvasculature, which if sufficiently severe, can produce organ dysfunction".³ It is advantageous to recognize and treat DIC early, as sequelae of the untreated disorder can be devastating.³

D-dimer is elevated in patients with DIC.² It is one of the most specific laboratory tests for this disorder as it indicates the presence of thrombin prior to fibrinolysis, thus distinguishing DIC from primary fibrinolysis.² Other diagnostic tests may include prothrombin time, platelet count, antithrombin III, fibrinogen and fibrin and fibrinogen degradation products.^1,2,3

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