What is the pathogenesis of hematologic derangements in disseminated intravascular coagulation (DIC)?

Updated: Dec 06, 2020
  • Author: Marcel M Levi, MD; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Answer

The hematologic derangements seen in DIC result from the following 4 simultaneously occurring mechanisms [17, 18] :

  • Tissue factor (TF)–mediated thrombin generation

  • Dysfunctional physiologic anticoagulant mechanisms (eg, depression of antithrombin and protein C system), which cannot adequately balance this thrombin generation

  • Impaired fibrin removal due to depression of the fibrinolytic system – This is mainly caused by high circulating levels of plasminogen activator inhibitor type 1 (PAI-1); however, in exceptional forms of DIC, fibrinolytic activity may be increased and contribute to bleeding

  • Inflammatory activation


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