Clinical meaning
DIC involves systemic activation of coagulation with simultaneous consumption of clotting factors and platelets causing both microvascular thrombosis and hemorrhage. Triggers: sepsis, trauma, malignancy, obstetric complications. Labs: prolonged PT/aPTT, low fibrinogen (<100), elevated D-dimer, thrombocytopenia, schistocytes on smear. Treatment: treat underlying cause, replace with FFP/cryo/platelets if bleeding, heparin only if thrombosis predominates.
Diagnosis & workup
Diagnostics & workup: - Bone marrow biopsy for unexplained cytopenias or suspected malignancy - Direct antiglobulin test (Coombs) for autoimmune hemolytic anemia - Flow cytometry for leukemia/lymphoma immunophenotyping - Peripheral smear morphology (schistocytes, spherocytes, target cells) - Haptoglobin (decreased in hemolysis), LDH (elevated in hemolysis) - PT/INR and aPTT for coagulation pathway assessment - D-dimer for DIC screening or fibrinolysis assessment
Risk factors: - Recent surgery or trauma with blood loss - Autoimmune conditions (ITP, AIHA, TTP-HUS) - Antiphospholipid syndrome with thrombotic risk - Chemotherapy-induced myelosuppression - Liver disease with coagulopathy and thrombocytopenia - Anticoagulant or antiplatelet therapy increasing bleeding risk - Malignancy with bone marrow infiltration or DIC