Disseminated Intravascular Coagulation (DIC)

Overview

What is disseminated intravascular coagulation (DIC)?

Disseminated intravascular coagulation is a rare and serious condition that can disrupt your blood flow. It is a blood clotting disorder that can turn into uncontrollable bleeding. DIC affects about 10% of all people who are very ill with sepsis, diseases such as cancer or pancreatitis, as well as people recovering from traumatic injuries such as burns or serious complications from pregnancy and delivery.

What happens in disseminated intravascular coagulation (DIC)?

First, DIC creates many small blood clots that might keep your blood from traveling through your body. When this happens, your blood might not be able to bring oxygen and nutrients to your head, heart and other organs. Then, having used up the proteins and platelets that make your blood clot, DIC might cause uncontrollable internal or external bleeding.

Who is affected by disseminated intravascular coagulation (DIC)?

DIC can be caused by infection, injury and several medical conditions. That means almost anyone can be affected by DIC. Risk factors include:

Can you survive disseminated intravascular coagulation (DIC)?

DIC can be life-threatening. You should seek immediate medical help if you’re being treated for sepsis, cancer or complications after giving birth and start to bleed for no reason, or if you have bleeding that you can’t stop.

Symptoms and Causes

What is a classic symptom of disseminated intravascular coagulation (DIC)?

One classic symptom is uncontrolled bleeding from several areas of your body. Other symptoms are:

  • Bruising.
  • Blood clots.
  • Confusion, memory loss or change of behavior.
  • Difficulty breathing.
  • Fever.

What causes disseminated intravascular coagulation (DIC)?

Disseminated intravascular coagulation has been linked to certain medical treatments or conditions. Medical treatments that can cause DIC include:

  • Blood transfusion reactions.
  • Recent surgery or anesthesia.
  • Complications from labor and delivery.

Medical conditions that can cause DIC include:

  • Cancer, especially certain types of leukemia.
  • Pancreatitis.
  • Blood infections.
  • Liver disease.
  • Severe tissue injury including burns and head injuries.
  • Unformed blood vessels called hemangioma.

Diagnosis and Tests

How do healthcare providers diagnose disseminated intravascular coagulation (DIC)?

Providers use several tests to diagnose DIC. Those tests are:

  • Complete blood count (CBC).
  • Partial thromboplastin time (PTT).
  • Prothrombin time (PT) test. This test measures the time it takes for your blood to clot.
  • Fibrinogen blood test. Fibrinogen is a protein in your blood that helps your blood to clot. This test measures your fibrinogen levels.
  • D-dimer. This is a blood test to check for blood clots.

Management and Treatment

What is the treatment for disseminated intravascular coagulation (DIC)?

Your healthcare provider’s first step is treating the underlying condition that caused you to develop DIC. They might use supportive treatments to improve blood flow if you have blood clots or to slow your blood loss. Those treatments are:

  • Plasma transfusions to reduce bleeding. Plasma transfusion replace blood clotting factors affected by DIC.
  • Transfusions of red blood cells and/or platelets.
  • Anti-coagulant medication (blood thinners) to prevent blood clotting.

Do anti-coagulant medications have side effects or complications?

If you have disseminated intravascular coagulation (DIC), you might be given anti-coagulant medication or blood thinners to prevent blood clots. Bleeding is a common side effect, including internal bleeding. Talk to your provider about side effects of anti-coagulants and any precautions you should take while using an anti-coagulant.

Prevention

How can I reduce my risk of developing disseminated intravascular coagulation (DIC)?

DIC is linked to medical conditions such as cancer, pancreatitis and liver disorders. Unfortunately, that means there’s very little you can do to prevent DIC. What you can do is to talk to your healthcare provider about DIC so you know what changes in your body might be a sign of it.

Outlook / Prognosis

What can I expect if I have disseminated intravascular coagulation (DIC)?

If you have DIC, you’re probably already coping with serious medical conditions such as sepsis and cancer, or you’re recovering from serious injuries. Fortunately, early diagnosis and supportive treatment can help to stop the blood clotting or bleeding that DIC causes so that your healthcare providers can focus on treating your underlying illnesses or injuries.

Living With

How can I best manage disseminated intravascular coagulation (DIC)?

Most people who have DIC are already coping with illness or a medical condition. Being diagnosed with disseminated intravascular coagulation means you have another medical concern to manage as you continue the treatment and testing for the medical condition that caused your DIC. Here are some suggestions that might help:

  • Take all medicines regularly, as your healthcare provider prescribes. Do not change the amount of your medicine or skip a dose unless they tell you to.
  • Ask your provider before taking any over-the-counter products such as pain relievers, vitamins, supplements or herbal remedies.
  • Talk with your provider about how often you should schedule office visits and blood tests to monitor the medications you’re taking.
  • If you’re taking blood thinners, make sure all your providers know so they can adjust treatment accordingly.

When should I go to the emergency room?

Disseminated intravascular coagulation can serious complications. You should go to the emergency room right away if you have:

What questions should I ask my healthcare provider?

Disseminated intravascular coagulation (DIC) is a rare disorder that’s been linked to several diseases and medical treatments. If you have DIC, you’ll probably have questions and want to know what to expect. Here are some basic questions you might ask your healthcare provider:

  • What is DIC?
  • Why did I develop this condition?
  • What are the chances I’ll have DIC again?
  • Are there symptoms I can monitor?
  • What medications treat DIC?
  • How long will I need to take these medications?
  • What are the medications’ side effects?
  • How will the medications interact with medications I’m taking for other medical conditions?

A note from Cleveland Clinic

If you’ve been diagnosed with disseminated intravascular coagulation, likely you’re already dealing with other serious medical issues. You might feel overwhelmed by an additional illness that means more symptoms to monitor and medications to take. Talk to your healthcare provider if you’re feeling overwhelmed by your medical challenges. They’ll understand what you’re going through and will have suggestions for programs or services.

Last reviewed by a Cleveland Clinic medical professional on 09/28/2021.

References

  • Costello RA, Nehring SM. Disseminated Intravascular Coagulation. (https://www.ncbi.nlm.nih.gov/books/NBK441834/) StatPearls. Accessed 10/11/2021.
  • Merck Manuals. Disseminated Intravascular Coagulation (DIC). (https://www.merckmanuals.com/home/blood-disorders/bleeding-due-to-clotting-disorders/disseminated-intravascular-coagulation-dic) Accessed 10/11/2021.
  • National Health Institutes. Disseminated Intravascular Coagulation. (https://www.nhlbi.nih.gov/health-topics/disseminated-intravascular-coagulation) Accessed 10/11/2021.
  • Papageorgiou C, Jourdi G, Adjambri E, Walborn A. Disseminated Intravascular Coagulation: An Update on Pathogenesis, Diagnosis, and Therapeutic Strategies. (https://pubmed.ncbi.nlm.nih.gov/30296833/) Clin Appl Thromb Hemost. Accessed 10/11/2021.
  • Sepsis Alliance. Disseminated Intravascular Coagulation. (https://www.sepsis.org/sepsisand/disseminated-intravascular-coagulation-dic/) Accessed 10/11/2021.

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