Disseminated intravascular coagulation (DIC) is a serious condition that causes problems with blood clotting and bleeding. It occurs due to an underlying health condition, such as sepsis or cancer.
In this article, we will explain what DIC is, including its symptoms, causes, treatments, and outlook.
DIC occurs when the body loses control of its blood clotting process.
Blood clots help stop bleeding in the event of an injury. The body needs platelets and coagulation factors to create clots. Platelets are a type of blood cell, while coagulation factors are proteins that cause clots to form.
In DIC, the proteins responsible for the clotting process become
This is the first stage of DIC. In the second stage, the blood clots so much that it runs out of platelets and coagulation factors. This results in uncontrolled bleeding, which can occur just under the skin, in the nose or mouth, or inside the body.
The symptoms of DIC can vary depending on whether a person is at the first or second stage. However, its overall symptoms
- bleeding from a wound site
- bleeding from the nose, mouth, or gums
- bleeding in the rectum or vagina
- blood in the stool or urine
- small dots or larger patches of bruising
- chest pain
- pain, warmth, and swelling in the leg
If a person experiences any signs of a blood clot or develops unexplained or uncontrollable bleeding, they should dial 911 or seek immediate medical attention.
Inflammation from an infection, injury, or illness
Sepsis is the most common cause of DIC. A person with sepsis has a body-wide response to infection that causes inflammation. Around 35% of people with sepsis also develop DIC.
DIC can also result from:
- Major organ damage: This may be due to cirrhosis of the liver, pancreatitis, a severe injury or burn, or major surgery.
- A severe immune reaction: This could be due to a failed blood transfusion, the body rejecting a transplanted organ, or exposure to a toxin, such as snake venom.
- Serious pregnancy complications: This includes amniotic fluid leaking into the bloodstream, significant bleeding mid- or post-delivery, or placental abruption. The latter involves the placenta separating from the uterus during pregnancy.
Additionally, cancer can also lead to DIC.
To diagnose DIC, a doctor will review a person’s medical history, carry out a physical examination, and perform tests.
While there is no single test that can diagnose DIC, in
- platelet count
- prothrombin time, or how long it takes the blood to clot
- markers of fibrin, an important substance for making blood clots
- levels of fibrinogen, a substance the body converts into fibrin after an injury
A person in the second stage of DIC will have low platelets, low fibrinogen, and a long clotting time.
If the cause of DIC is unclear, doctors will also perform tests to look for an underlying health condition. Often, people with DIC have a life threatening condition that also requires treatment.
In the first stage of DIC, a blood thinner may help stop blood from clotting, preventing organ damage. However, a person may reach stage two and experience major bleeding or have a high risk of complications due to hemorrhage. In this case, they may need a transfusion of plasma, platelets, or clotting factors.
Doctors will only consider administering platelets and plasma if a person:
- is experiencing active bleeding
- is at high risk of bleeding
- needs to undergo an invasive medical procedure
Treatment for the underlying condition will vary depending on a person’s circumstances. For example, it
- antibiotics for sepsis
- exploratory surgery for people who may have internal injuries
- early delivery, if possible, for pregnant people with placental abruption
DIC is a serious condition, and it can lead to complications. These include:
- life threatening bleeding
- gangrene, when tissue dies due to a lack of oxygen-rich blood
- venous thromboembolism
- heart attack
- acute kidney failure
- medical shock
Some people with DIC can recover, but the mortality rate is high. In people with sepsis or trauma, DIC
A person with an acute and reversible condition may be able to make a full recovery, but this depends on their condition and how quickly they receive treatment. Early and prompt treatment increases the chances of a positive outcome.
Recovering from DIC may take a long time, as the condition can affect many organ systems. A person may need a team of healthcare professionals from multiple specialisms to survive and recover.
DIC is a condition that causes blood to clot uncontrollably. When the body runs out of platelets and proteins to create blood clots, a person experiences bleeding. This may occur in the mouth, rectum, vagina, or under the skin.
DIC is always the result of another condition, and the underlying cause is