Differences and similarities between disseminated intravascular coagulation and thrombotic microangiopathy

Abstract

IntroductionBoth disseminated intravascular coagulation (DIC) and thrombotic microangiopathy (TMA) cause microvascular thrombosis associated with thrombocytopenia, bleeding tendency and organ failure.Reports and discussionThe frequency of DIC is higher than that of thrombotic thrombocytopenic purpura (TTP). Many patients with TMA are diagnosed with DIC, but only about 15% of DIC patients are diagnosed with TMA. Hyperfibrinolysis is observed in most patients with DIC, and microangiopathic hemolytic anemia is observed in most patients with TMA. Markedly decreased ADAMTS13 activity, the presence of Shiga-toxin-producing Escherichia coli (STEC) and abnormality of the complement system are useful for the diagnosis of TTP, STEC-hemolytic uremic syndrome (HUS)and atypical HUS, respectively. However, there are no specific biomarkers for the diagnosis of DIC.ConclusionAlthough DIC and TMA are similar appearances, all coagulation, fibrinolysis and platelet systems are activated in DIC, and only platelets are markedly activated in TMA.

Acute Respiratory Distress Syndrome as an Organ Phenotype of Vascular Microthrombotic Disease: Based on Hemostatic Theory and Endothelial Molecular Pathogenesis

“…"DIC", TTP, HUS, TTP-like syndrome, and thrombotic microangiopathy are similar but "different diseases." [77][78][79][80][81][82] (Instead, all of them are the same disease called "TTPlike syndrome" except TTP [GA-VMTD and AA-VMTD]. 9 ) "DIC" did not respond to any therapeutic agent utilized in clinical trials.…”

Thrombotic Microangiopathy Score as a New Predictor for Neurologic Outcome in Patients Undergoing Targeted Temperature Management After Out-of-hospital Cardiac Arrest

“…DIC and TMA show similar laboratory ndings and presenting symptoms [32]. Although microvascular thrombosis is mainly caused by platelet activation in both DIC and TMA, DIC is signi cantly associated with all coagulation and brinolysis systems, while TMA is signi cantly associated with vascular endothelial cells [33]. Thrombotic thrombocytopenic purpura and hemolytic uremic syndrome are known as the classic forms of TMA [34].…”

“…Thrombotic thrombocytopenic purpura and hemolytic uremic syndrome are known as the classic forms of TMA [34]. Despite differences in the mechanisms of underlying DIC and TMA [33], several different conditions, such as atypical hemolytic uremic syndrome, DIC, and drug toxicities, can be also considered as different forms of TMA [34]. It is di cult to use the schistocyte count as a complete indicator for the initial diagnosis and con rmation of TMA and DIC [13].…”

The role of Contrast-Enhanced Ultrasound for evaluating renal perfusion dynamics in partially reversible acute cortical kidney ischemia in a patient with sepsis

“…Sepsis represents the most frequent cause of AKI in critically ill patients. It associates a dysregulated inflammatory host response to infection, which leads to over Commonly, the differential diagnosis between DIC and TMA is difficult, the two pathologies often being associated [9]. Abnormal values of the coagulation tests, including D-dimers, prothrombin time and fibrinogen, are suggestive of DIC, TMA generally presenting normal values [4].…”