Disseminated Intravascular Coagulation (DIC) and Thrombotic Disorders
Disseminated intravascular coagulation is a devastating clinical syndrome triggered by systemic activation of the coagulation cascade. DIC is always an acquired syndrome; occurring because of a primary disease. Many common diseases are capable of initiating DIC, including neoplasia, shock, sepsis, pancreatitis, and hemolytic anemia. The disease process is dynamic, with early thrombosis progressing to diffuse bleeding. The clinical signs of DIC are highly variable and depend on the underlying disease and the balance between thrombosis and hemorrhage.
Identification of DIC and Thrombotic Disorders
To identify DIC and thrombosis, use the following tests:
Antithrombin is a natural anticoagulant, and is often depleted during thrombus formation in active DIC. Antithrombin loss also accompanies protein-losing nephropathies and enteropathies, leading to a hypercoagulable state and risk for thrombosis in these conditions.
D-dimer is a breakdown product of cross-linked fibrin.
Plasminogen is the inactive precursor of the fibrinolytic enzyme plasmin.