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    DIC-Patho B Homework

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    Mikee Melad
    Disseminated Intravascular Coagulation (DIC) is a thrombohemorrhagic disease characterized by extreme activation of the coagulation system leading to thrombi formation in the microvasculature. It is not a primary disease but can be caused by various underlying conditions like cancer, infection, trauma through the release of tissue factors and endothelial injury. This leads to widespread fibrin deposition in the microvasculature, consumption of platelets and clotting factors. Treatment involves removing the underlying cause and administering anticoagulants or procoagulants.

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    DIC-Patho B Homework

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    Mikee Melad
    27 views2 pages
    Disseminated Intravascular Coagulation (DIC) is a thrombohemorrhagic disease characterized by extreme activation of the coagulation system leading to thrombi formation in the microvasculature. It is not a primary disease but can be caused by various underlying conditions like cancer, infection, trauma through the release of tissue factors and endothelial injury. This leads to widespread fibrin deposition in the microvasculature, consumption of platelets and clotting factors. Treatment involves removing the underlying cause and administering anticoagulants or procoagulants.

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    DIC-Patho b Homework

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    Disseminated Intravascular Coagulation (DIC) is a thrombohemorrhagic disease characterized by extreme activation of the coagulation system leading to thrombi formation in the microvasculature. It is not a primary disease but can be caused by various underlying conditions like cancer, infection, trauma through the release of tissue factors and endothelial injury. This leads to widespread fibrin deposition in the microvasculature, consumption of platelets and clotting factors. Treatment involves removing the underlying cause and administering anticoagulants or procoagulants.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    27 views2 pages

    DIC-Patho B Homework

    Uploaded by

    Mikee Melad
    Disseminated Intravascular Coagulation (DIC) is a thrombohemorrhagic disease characterized by extreme activation of the coagulation system leading to thrombi formation in the microvasculature. It is not a primary disease but can be caused by various underlying conditions like cancer, infection, trauma through the release of tissue factors and endothelial injury. This leads to widespread fibrin deposition in the microvasculature, consumption of platelets and clotting factors. Treatment involves removing the underlying cause and administering anticoagulants or procoagulants.

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    CO, Jian Meryl C.

    PathoB-2J

    Disseminated Intravascular Coagulation (DIC) Overview DIC is a thrombohemorrhagic disease which may be presented in acute, subacute or chronic setting. It is characterized by extreme activation of the coagulation system of the body leading to the formation of thrombi in the microvasculature of the body. Excessive coagulation then leads to the 1)expenditure of the coagulation factors including as well platelets and fibrin 2)activation of fibrinolysis. Etiology and Pathogenesis It is important to note that DIC is not a primary disease.it may be caused as a consequence of various disease entities such as cancer, obstetric complications, infectious diseases and burns. There are two major mechanisms which serve as trigger to the occurence of DIC a)release of tissue factor/ thromboplastic substances into the circulation and b) widespread injury to the endothelial cells. Endothelial injury. This leads to generation of DIC by 1)exposure of subendothelial matrix that stimulates platelet activation and coagulation pathway. Tumor Necrosis Factor (TNF) a clinically significant procoagulant mediator seen in sepsis. It activates endothelial cells into expressing tissue factor on their cell surfaces and decreases expression of thrombomodulin (an anticoagulant). TNF as well promotes adhesion molecule expression that permits further leukocyte adhesion. This causes generation of free radicals and preformed proteases leading to endothelial damage. For Systemic Lupus Erythematosus (SLE), a prominent mechanism by which TNF contributes to the occurrence of DIC through deposition of antigen-antibody complexes. Same mechanism is also found in temperature extremes (heat stroke, burns) or infectious diseases caused by meningococci, rickettsiae). Obstetric complications, malignant neoplasms, sepsis and major trauma. In obstetric conditions placenta, dead retained fetus or amniotic fluid that find entry to circulation serve as prelude to DIC since these contain thromboplastin. As for malignant neoplasms the most frequently associated to DIC include adenocarcinomas of the lung, pancreas, colon and stomach. For sepsis, DIC is implicated through endothelial cell injury caused by endotoxins and induction of thromboplastin release from inflammatory cells. There is also activation of the classical complement pathway that resulted from deposition of antigen- antibody complexes. In massive trauma or extensive surgery, main trigger for DIC is the release of tissue thromboplastins. Consequences of DIC include widespread fibrin deposition located inside the microvasculature leading to ischemia and consumption of plates and clotting factors as wells as plasminogen activation.

    Morphology Clinical evidences of DIC exist in the form of thrombi found in these organs with decreasing frequency 1)brain 2)heart 3)lungs 4)kidney 5)adrenals 6)spleen 7)liver. Thrombi in kidneys are found specifically in the glomeruli. In the lung fimbrin thrombi are found in the alveolar capillaries. In addition, DIC can also be manifested with pulmonary edema. In CNS, microinfarcts can also be found. If DIC is secondary to meningococcemia, adrenal hemorrhages are seen. In obstetric complications, Sheehan postpartum pituitary necrosis is seen. Clinical Manifestations DIC can either be fulminant or insidious when seen in chronic conditions. Its features include microangiopathic hemolytic anemia, dyspnea, cyanosis and respiratory failure. For laboratory workup measurement of fibrinogen levels, platelets, PT and PTT and fibrin degradation products can be done. Treatment Main definitive treatmen is removal of the etiological cause of DIC in a patient. Administration of anticoagulants or procoagulation can also serve as supplement for treating DIC.

    Reference: Kumar, V. et. al. Robbins and Cotran Pathologic Basis of Disease. 2010. 8th ed. Saunders. pp.673-674

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