In this article, we will discuss the Clinical Features of DIC (Disseminated intravascular coagulation). So, let’s get started.
The clinical presentation varies with the stage and severity of the syndrome. It may be asymptomatic (laboratory parameters provide the diagnosis) or may present with florid thrombo-hemorrhagic manifestations and shock.
Hemorrhage is the most common presentation characterized by spontaneous bruising, mucosal bleeding/oozing or bleeding from open wound and venipuncture or catheter sites. Usually bleeding is associated with varying degree of shock which is out of proportion to the degree of blood loss. Shock is probably due to cytokines. The major organ dysfunction leading to syndrome of DIC involving the pulmonary, renal, hepatic and CNS systems can occur.
Less often, patients present with thrombotic manifestations, i.e. acrocyanosis, thrombosis and pregangrenous changes in the digits, genitalia and nose-area where blood flow is markedly reduced by vasospasm aur microthrombi.
DIC maybe acute or chronic. Acute DIC is commonly seen in clinical practice manifests with bleeding that can be rapidly progressive. Acrocyanosis is common during acute DIC due to microthrombi or vasospasms of the digital vessels. On the other hand, chronic disease occur from a weak or intermittent activating stimulus. In this type, the production and destruction of clotting factors and platelets is balanced called compensated DIC. Patients may have episodes of mild bleeding or ecchymosis. Trousseau’s syndrome is a chronic form of DIC. Chronic DIC seen in patients with intrauterine fetal death, adenocarcinomas of various organs, vasculitis, aortic aneurysm and giant hemangioma.
HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) is a severe form of DIC, carries high mortality, occurs in peripartum women.
There may be renal dysfunction also due to gross hemoglobinuria.