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: - Iron studies: serum iron, TIBC, ferritin, transferrin saturation - Flow cytometry for leukemia/lymphoma immunophenotyping - B12 and folate levels (methylmalonic acid if B12 borderline) - Bone marrow biopsy for unexplained cytopenias or suspected malignancy - CBC with differential and peripheral blood smear review - Direct antiglobulin test (Coombs) for autoimmune hemolytic anemia - Haptoglobin (decreased in hemolysis), LDH (elevated in hemolysis)
Risk factors: - B12 or folate deficiency (vegans, malabsorption, metformin use) - Antiphospholipid syndrome with thrombotic risk - Chronic kidney disease with decreased erythropoietin - Recent surgery or trauma with blood loss - Iron deficiency (most common cause of anemia worldwide) - Autoimmune conditions (ITP, AIHA, TTP-HUS) - Liver disease with coagulopathy and thrombocytopenia