Disseminated intravascular coagulation: Clinical and laboratory aspects

Abstract

Disseminated intravascular coagulation (DIC) is a complex acquired coagulopathy resulting from excessive thrombin formation. Abnormal tissue factor (TF) expression is a major mechanism initiating DIC in many disorders, including obstetrical complications, sepsis, cancer, and trauma. Numerous laboratory tests are available to monitor DIC, but most patients are adequately managed using only routine hemostasis screening tests, and assays for fibrinogen and D-dimer. Treatment of DIC should focus on reversing the underlying disorder initiating the coagulopathy. Novel treatments are being investigated for treating DIC; many of these experimental modalities target the excessive TF activity that characterizes DIC. Am. J. Hematol. 59:65-73, 1998.

Acquired coagulant factor VIII deficiency induced byBacillus anthracislethal toxin in mice

“…26 The reaction of thrombin (coagulation factor II) with its major inhibitor antithrombin III causes formation of thrombin-antithrombin (TAT). 27 Therefore, D-dimer and TAT are both proteolytic products of coagulation factors after the activation of coagulation and subsequent fibrinolytic cascades.…”

“…27 Therefore, D-dimer and TAT are both proteolytic products of coagulation factors after the activation of coagulation and subsequent fibrinolytic cascades. 26,28 Consequently, elicitation of circulating D-dimer and TAT suggests an induction of coagulation activation or disseminated intravascular coagulation (DIC). 26,28 To investigate role of LT on the induction of DIC, which was reported in B. anthracis-challenged animals, [29][30][31] we analyzed the plasma levels of D-dimer and TAT complex ( Fig.…”

Coagulation and cancer: Implications for diagnosis and management

“…12,17 A potential role of cytokines in diffuse DIC has also been supported, as the influences of inflammation and cytokines on the clotting system have become increasingly recognized. 27 DIC is associated with all hematological malignancies, particularly acute promyelocytic leukaemia (APL), with incidence up to 100%, but it may also accompany various solid tumors, such as pancreatic, gastrointestinal and prostate cancer.…”

Comparison of Diagnostic Accuracies in Outpatients and Hospitalized Patients of D-Dimer Testing for the Evaluation of Suspected Pulmonary Embolism

“…D-Dimer testing has been used to aid in the diagnosis of disseminated intravascular coagulation (1)(2)(3). Recently, however, these tests have been studied for the exclusion of thromboembolic disease in patients suspected of having pulmonary embolism (PE) 5 or deep vein thrombosis (DVT) (4 -6 ).…”