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Disseminated Intravascular Coagulation, DIC: Symptoms, Causes, Tests, Treatments and Prognosis

  • 📗 Medical

Disseminated Intravascular Coagulation (DIC) refers to coagulation in the blood as a reaction to substances in the tissue due to exposure of damaged tissue to the blood when there is a disease such as infection, malignant tumor, severe trauma or bleeding. When there is severe inflammation throughout the body, substances that promote the formation of blood clots may be secreted from monocytes and endothelial cells in the blood. Through this process, blood clots are spontaneously generated in the blood. In this process, coagulation factors are exhausted and the hemostatic action does not occur normally, resulting in uncontrolled bleeding.

Symptoms

Symptoms of Disseminated Intravascular Coagulation vary depending on the type and severity of the underlying disease. In the case of mild patients, abnormalities are sometimes found only in the examination findings without any symptoms. Microthrombosis generated in blood vessels can block capillaries, resulting in necrosis of fingers or limbs. Among internal organs, the lungs and kidneys are most commonly involved, and acute renal failure may occur due to pulmonary embolism and necrosis of the renal cortex. In addition, the brain, heart, liver, and intestines can also cause symptoms. The exhaustion of clotting factors increases the tendency of bleeding throughout the body, resulting in hemorrhagic spots on the skin and blood effusion on the surface of the mucous membrane, and in some cases, fatal bleeding occurs in the brain and gastrointestinal tract.

Causes

Numerous diseases can cause Disseminated Intravascular Coagulation, but the most important causes are infectious diseases and malignant diseases. In the case of infectious diseases, toxins secreted directly from the blood by bacteria often cause coagulation, and in some tumor diseases, it is caused by the action of the tumor cells themselves. Burns, crush injuries and ischemic injuries promote the formation of extensive blood clots by exposing substances in the tissue to the blood as the vessel wall is destroyed.

Diagnostic criteria

Disseminated Intravascular Coagulation is diagnosed according to established standards based on blood counts in peripheral blood and coagulation function tests.

Test methods

There is no specific test method for diagnosing Disseminated Intravascular Coagulation, and it is diagnosed by measuring the blood count and coagulation factor concentration through a blood test. In addition, in order to exclude the possibility of other diseases showing symptoms similar to Disseminated Intravascular Coagulation, clinical judgment based on the individual patient’s medical history is essential.

Treatments

There is no specific treatment for Disseminated Intravascular Coagulation itself. The most important thing is to accurately diagnose and treat the underlying disease that caused it. If there is no symptom and only a minor abnormality is shown in the test findings, it can be observed without special treatment. In patients with severe bleeding, platelets or coagulation factor drugs (fresh frozen plasma, cryoprecipitation drugs) can be transfused. Drugs such as heparin can be administered to prevent the consumption of clotting factors, but caution is required because there is a risk of worsening bleeding.

Progress and complications

The course varies greatly depending on the type of underlying disease and the severity of the Disseminated Intravascular Coagulation itself. Patients with no or mild symptoms may improve on their own, but some patients die due to severe bleeding and dysfunction of various organs due to blood clots.

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