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, incidence, and risk factors

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. 

Over time, the clotting proteins in your blood are "used up." When this happens, you have a higher risk for serious bleeding, even from a minor injury or without injury. You may also have bleeding that starts 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)

Symptoms

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

Signs and tests

You may have the following tests:

Treatment

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

There is no specific treatment for DIC. Treatments may include:

  • Plasma transfusions to replace blood clotting factors
  • Blood thinner medicine (heparin) to prevent blood clotting

 

Expectations (prognosis)

The outcome depends on what is causing the disorder. 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.

Figures

References

 Schafer AI. Hemorrhagic disorders: disseminated intravascular coagulation, liver failure, and vitamin K deficiency. In: Goldman L, Ausiello D, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 178.

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.

Revision

Last reviewed 11/17/2012 by Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

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