Disseminated intravascular coagulation

Disseminated intravascular coagulation is a syndrome of systemic coagulation activation that forms fibrin-rich microthrombi while consuming platelets and clotting factors, creating risks of organ dysfunction and bleeding.

Tissue factor: A cell-surface protein that initiates the extrinsic coagulation pathway when exposed to blood. Its exposure in severe illness can drive the thrombin generation that starts DIC.
D-dimer: A protein fragment released when plasmin breaks down cross-linked fibrin. Its concentration often rises when DIC produces and degrades large amounts of fibrin.
Obstetric emergency: A sudden complication of pregnancy, childbirth, or the postpartum period requiring urgent medical care. Several obstetric crises can trigger DIC through tissue injury, shock, or release of procoagulant material.
Thrombotic thrombocytopenic purpura: A thrombotic microangiopathy caused by severe deficiency of the von Willebrand factor-cleaving enzyme ADAMTS13. It causes thrombocytopenia and hemolysis but usually lacks the coagulation-test abnormalities typical of DIC.
Thrombin: A coagulation enzyme that converts fibrinogen into fibrin and activates several clotting factors and platelets. Excessive thrombin generation links systemic coagulation activation to fibrin deposition.
Prothrombin time: A blood test measuring clotting time through the extrinsic and common coagulation pathways. It may become prolonged as clotting factors are consumed in DIC.
Placental abruption: Premature separation of the placenta from the uterine wall before delivery. Severe abruption can release tissue factor and precipitate obstetric DIC.
Hemolytic uremic syndrome: A thrombotic microangiopathy characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. Like DIC, it can damage small vessels, but its coagulation tests are often relatively preserved.
Fibrin: An insoluble protein polymer that forms the structural mesh of a blood clot. Fibrin accumulates in small vessels during DIC and contributes to impaired tissue perfusion.
Fibrinogen: A soluble plasma protein converted by thrombin into fibrin during blood clotting. Low or falling fibrinogen can reflect consumption, though inflammation may initially keep levels normal.

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