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Disseminated intravascular coagulation (DIC)
Also known as disseminated intravascular coagulopathy or less commonly as consumptive coagulopathy, is a pathological process characterized by the widespread activation of the clotting cascade that results in the formation of blood clots in the small blood vessels throughout the body. This leads to compromise of tissue blood flow and can ultimately lead to multiple organ damage. In addition, as the coagulation process consumes clotting factors and platelets, normal clotting is disrupted and severe bleeding can occur from various sites.
Symptoms:
- Multiple bleeding sites
- Bruising of skin, mucous membranes
- Internal bleeding
- Lack of blood supply to tissues (ischaemia)
- Sudden onset of high fever, severe general malaise, and extensive purpura of the extremities
- Petechiae, purpuric papules, blood-filled blisters and bluish fingers and toes
Preliminary plan:
- General practitioner appointment
- Complete blood count (CBC)
- Reticulocyte count
- Urinalysis
- Blood group + RhD
- Stool analysis - Protozoans and Helminths (microscopy)
- Blood test:
- Latent iron-binding capacity
- Iron
- Vitamin B12 (cyanocobalamin)
- Transferrin
- Ferritin
- Folic acid (folates)
- Potassium Sodium Chlorine (K, Na, Cl) (blood)
- Urea (BUN)
- Creatinine
- Glucose
- Cholesterol
- Triglycerides
- Alkaline phosphatase (ALP)
- Alanine transaminase (ALT)
- Bilirubin (total, direct)
- Blood clotting test:
- Prothrombin ratio (PR) / International normalized ratio (INR)
- Fibrinogen
- Thrombin time
- aPTT
- Antithrombin III (AT-III)
- D-dimer
- Lupus anti-coagulant
- Protein C
- Protein S, free
- Coagulogram