Disseminated intravascular coagulation
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Disseminated intravascular coagulation (DIC) p. 435
acute myelogenous leukemia p. 440
amniotic fluid emboli p. 697
Ebola p. NaN
endotoxins p. 129, 131
meningococci p. 140
microangiopathic anemia p. 417
placental abruption p. 664
schistocytes in p. 424
Waterhouse-Friderichsen syndrome p. 355, 716
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Disseminated intravascular coagulation, or DIC, describes a situation in which the process of hemostasis, which is when after blood vessel wall injury, liquid blood rapidly becomes a gel, called coagulation or clotting, starts to run out of control.
When this happens, lots and lots of blood clots start to form in blood vessels serving various organs, leading to organ ischemia.
DIC, though, is also called a consumption coagulopathy, because all this clotting consumes platelets and clotting factors.
Without enough platelets circulating in the blood, other parts of the body begin to bleed with even the slightest damage to the blood vessel walls. So paradoxically, patients have too much and too little clotting.
Normally, after a cut and damage to the endothelium, or inner lining of blood vessel walls, there’s an immediate vasoconstriction or narrowing of the blood vessel which limits the amount of blood flow.
After that, some platelets adhere to the damaged vessel wall, and become activated and then recruit additional platelets to form a plug.
The formation of the platelet plug is called primary hemostasis.
After that, the coagulation cascade is activated. First off in the blood there’s a set of clotting factors, most of which are proteins synthesized by the liver, and usually these are inactive and just floating around in the blood.
The coagulation cascade starts when one of these proteins gets proteolytically cleaved.
This active protein then proteolytically cleaves and activates the next clotting factor, and so on.
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
- "How I treat disseminated intravascular coagulation" Blood (2018)
- "Diagnosis and management of sepsis‐induced coagulopathy and disseminated intravascular coagulation" Journal of Thrombosis and Haemostasis (2019)
- "Disseminated Intravascular Coagulation: An Update on Pathogenesis, Diagnosis, and Therapeutic Strategies" Clinical and Applied Thrombosis/Hemostasis (2018)
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