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== [[Disseminated intravascular coagulation classification|Classification]]==
== [[Disseminated intravascular coagulation classification|Classification]]==
[[Disseminated intravascular coagulation]] may be classified according to the degree of fibrinolytic activation into suppressed-fibrinolytic-type DIC (DIC with suppressed fibrinolysis), enhanced-fibrinolytic-type DIC (DIC with enhanced [[fibrinolysis]]) and balanced-fibrinolytic-type DIC (DIC with balanced [[fibrinolysis]]). Each type differs in clinical features and laboratory findings.
== [[Disseminated intravascular coagulation pathophysiology|Pathophysiology]] ==
== [[Disseminated intravascular coagulation pathophysiology|Pathophysiology]] ==
DIC is a hemorrhagic syndrome originating in the small blood vessels. DIC is caused by uncontrolled activation of clotting factors and fibrinolytic enzymes. Tissue necrosis and bleeding are results of DIC. Under [[Homeostasis|homeostatic]] conditions, the body is maintained in a finely tuned balance of [[coagulation]] and [[fibrinolysis]]. The activation of the [[coagulation]] cascade yields [[thrombin]] that converts [[fibrinogen]] to [[fibrin]]; the stable [[fibrin]] clot being the final product of [[hemostasis]]. The fibrinolytic system then functions to break down [[fibrinogen]] and fibrin. Activation of the [[Fibrinolysis|fibrinolytic]] system generates [[plasmin]] (in the presence of [[thrombin]]), which is responsible for the lysis of [[fibrin]] clots. The breakdown of [[fibrinogen]] and fibrin results in [[polypeptides]] called [[fibrin degradation products]] (FDPs) or [[fibrin split products]] (FSPs). In a state of [[homeostasis]], the presence of [[thrombin]] is critical, as it is the central [[proteolytic]] [[enzyme]] of coagulation and is also necessary for the breakdown of clots, or [[fibrinolysis]].
== [[Disseminated intravascular coagulation causes|Causes]] ==
== [[Disseminated intravascular coagulation causes|Causes]] ==
There are a variety of causes of [[DIC]], all usually causing the release of [[chemicals]] into the [[blood]] that instigates the [[coagulation]]. Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. [[Disseminated intravascular coagulation]] in itself is a life-threatening condition and must be treated as such irrespective of the cause. Common causes include [[abruptio placentae]], [[amniotic fluid embolism]], [[aortic aneurysm]], [[blood transfusion]] reaction, drugs (e.g. [[Amphetamines]]), beractant [[eclampsia]], giant [[hemangioma]], [[graft-versus-host disease]], [[HELLP syndrome]] and hemolytic transfusion reaction.
== [[Disseminated intravascular coagulation differential diagnosis|Differentiating Disseminated intravascular coagulation from other Diseases]] ==
== [[Disseminated intravascular coagulation differential diagnosis|Differentiating Disseminated intravascular coagulation from other Diseases]] ==
Disseminated intravascular coagulation (DIC) must be differentiated from other diseases that cause symptoms of [[DVT]] and [[pulmonary embolism]] such as: [[factor V Leiden mutation]], [[protein C deficiency]], [[protein S deficiency]], [[Prothrombin gene mutation G20210A|prothrombin gene mutation]], [[antithrombin III deficiency]], [[antiphospholipid antibody syndrome]].
== [[Disseminated intravascular coagulation epidemiology and demographics|Epidemiology and Demographics]] ==
== [[Disseminated intravascular coagulation epidemiology and demographics|Epidemiology and Demographics]] ==
The incidence of [[DIC]] is different in different [[diseases]] as it is almost always related to a life threatening condition. It depends on the cause of DIC such as cancer, infection, trauma and Obstetrical complications. The incidence of [[DIC]] is different in different [[diseases]] as it is almost always related to a life threatening condition. It depends on the cause of DIC such as [[cancer]], [[infection]], [[trauma]] and [[obstetrical]] complications. The [[prevalence]] of [[DIC]] depends on the clinical settings, higher versus low acquity settings. The data sometimes may underestimate the incidence of trasient or mild cases of DIC.
== [[Disseminated intravascular coagulation risk factors|Risk Factors]] ==
== [[Disseminated intravascular coagulation risk factors|Risk Factors]] ==
Common risk factors in the development of [[DIC]] include [[trauma]], [[sepsis]], [[obstetric]] complications, [[cancers]], and [[Immunological|immunologic]] reactions
== [[Disseminated intravascular coagulation screening|Screening]] ==
== [[Disseminated intravascular coagulation screening|Screening]] ==
There is insufficient evidence to recommend routine screening for DIC as it does not suggest any changes in mortality except in [[sepsis]]
== [[Disseminated intravascular coagulation natural history, complications and prognosis|Natural History, Complications and Prognosis]] ==
== [[Disseminated intravascular coagulation natural history, complications and prognosis|Natural History, Complications and Prognosis]] ==
If left untreated, 40-80% patients with DIC may progress to develop organ dysfunction. Common complications of DIC include [[renal failure]], [[hepatic dysfunction]], [[acute lung injury]], neurologic dysfunction and [[adrenal failure]]. Low levels of [[antithrombin]] at the onset if shock may predict an unfavorable [[prognosis]].
== Diagnosis ==
== Diagnosis ==



Latest revision as of 18:06, 20 September 2018



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Disseminated intravascular coagulation or Disseminated intravascular coagulopathy
ICD-10 D65
ICD-9 286.6
DiseasesDB 3765
MedlinePlus 000573
MeSH D004211

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omer Kamal, M.D.[2], M. Khurram Afzal, MD [3], Sogand Goudarzi, MD [4]

Synonyms and keywords: Disseminated intravascular coagulation, Disseminated intravascular coagulopathy, Consumptive coagulopathy, DIC

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Disseminated intravascular coagulation from other Diseases

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Diagnosis

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