ReviewDisseminated intravascular coagulation
Section snippets
History
The underlying condition in the first report of disseminated intravascular coagulation (DIC) was gynecological disease, which was followed by the report of several cases of DIC associated with leukemias and solid cancers. The concept of DIC was established from these reports. The detection of microthrombi in patients with DIC called for the use of heparin in patients with bleeding. Treatment of hemorrhage due to consumption coagulopathy was the primary goal of therapy. Although several groups
Pathophysiology
Based on the 1997 survey study of DIC by JMHW, the frequency of DIC per hospitalized patient was 1.72% in Japan. Underlying diseases frequently associated with DIC in these patients were acute promyelocytic leukemia (APL), fulminant hepatitis and sepsis. As can be seen, most patients with DIC had sepsis, non-Hodgkins lymphoma or hepatoma (Table 2). While DIC is a condition characterized by overactivation of both the coagulation and fibrinolysis systems in the systemic microvasculature, it was
Definition and concept
Although various definitions have been advocated for DIC by many researchers, these definitions typically never agree with each other [8]. The JMHW has defined the diagnostic criteria of DIC and its definition is widely used in Asian countries. However, the JMHW has not provided a satisfactory definition of DIC because these standards were initially designed to simplify the diagnosis of typical DIC [8]. Although detection of microthrombi was initially considered as necessary for the definition
Treatments
In leukemia and lymphoma, advances in adjuvant therapies such as antibiotics, granulocyte-colony stimulating factor (G-CSF), and blood transfusion, coupled with administration of all-trans-retinoic acid (ATRA) for APL, have decreased the frequency and mortality of DIC. However, the frequency and mortality of DIC are still high in ICU patients, especially those with sepsis.
References (52)
- et al.
Active site inhibited factor VIIa (DEGR VIIa) attenuates the coagulant and interleukin-6 and -8, but not tumor necrosis factor, responses of the baboon to LD 100 Escherichia coli
Blood
(1998) - et al.
Aggravation of endotoxin-induced disseminated intravascular coagulation and cytokine activation in heterozygous protein-C-deficient mice
Blood
(2003) - et al.
The endothelial protein C receptor aids in host defense against Escherichia coli sepsis
Blood
(2000) - et al.
Tissue factor pathway inhibitor gene disruption produces intrauterine lethality in mice
Blood
(1997) - et al.
Biphasic transmittance waveform in the APTT coagulation assay is due to formation of Ca2+-dependent complex of C-reactive protein with very low density lipoprotein and is a novel marker of impending disseminated intravascular coagulation
Blood
(2002) - et al.
A monoclonal antibody specific to the granulocyte-derived elastase-fragment D species of human fibrinogen and fibrin: its application to the measurement of granulocyte-derived elastase digests in plasma
Blood
(2000) - et al.
Clinical evaluation of low-molecular-weight heparin (FR-860) on disseminated intravascular coagulation (DIC)—a multicenter co-operative double-blind trial in comparison with heparin
Thromb Res.
(1993) - et al.
Potent inhibition of thrombin by the newly synthesized arginine derivative No. 805: the importance of stereo-structure of its hydrophobic carboxamide portion
Biochem. Res. Commun.
(1981) - et al.
Disseminated intravascular coagulation (DIC): an approach
Am. J. Med.
(1974) Disseminated intravascular coagulation: experience in a major cancer center
Thromb. Diath. Haemorrh.
(1975)
Clinical and laboratory aspects of disseminated intravascular coagulation (DIC): a study of 118 cases
Thromb. Haemost.
Disseminated intravascular coagulation. Findings in 346 patients
Thromb. Haemost.
Criteria for diagnosis of DIC based on the analysis of clinical and laboratory findings in 345 DIC patients collected by the Research Committee on DIC in Japan
Bibl. Haematol.
Attempts to define disseminated intravascular coagulation
Toward an epidemiology and natural history of SIRS (systemic inflammatory response syndrome)
JAMA
The SOFA (sepsis-related organ failure assessment) score to describe organ dysfunction/failure
Intensive Care Med.
High-dose antithrombin in severe sepsis. A randomized controlled trial
JAMA
Efficacy and safety of recombinant human protein C for severe sepsis
N. Engl. J. Med.
Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation—on behalf of the Scientific Subcommittee on disseminated intravascular coagulation (DIC) of the International Society on Thrombosis and Haemostasis (ISTH)
Thromb. Haemost.
Disseminated intravascular coagulation: clinical spectrum and established as well as new diagnostic approaches
Thromb. Haemost.
The pathophysiology of disseminated intravascular coagulation
Thromb. Haemost.
Disseminated intravascular coagulation
Thromb. Haemost.
Coagulant and fibrinolytic activities in the leukemic cell lysates
Thromb Res.
Two-stage response to endotoxin infusion into normal human subjects: correlation of blood phagocyte luminescence with clinical and laboratory markers of the inflammatory, hemostatic response
Crit. Care Med.
Plasma levels of Il-1β in disseminated intravascular coagulation
Thromb. Haemost.
Plasma level of tumor necrosis factor in disseminated intravascular coagulation
Am. J. Hematol.
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2017, Diagnostic Microbiology and Infectious DiseaseCitation Excerpt :The fibrinogen/CRP ratio was <104 in the bleeding group. In previous studies, the sensitivity of hypofibrinogenemia to predict DIC was reported as only 28% (Levi, 2007; Wada, 2004), but the fibrinogen/CRP ratio further enhanced the diagnostic power of DIC (Taylor et al., 2001). In this study, we showed that thrombocytopenia (<100,000 platelets/mm3) and a low fibrinogen/CRP ratio (<104) were hemostasis-related factors that were independently associated with clinical bleeding.
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