Disseminated Intravascular Coagulation (DIC)

Disseminated intravascular coagulation (DIC) is a blood clotting disorder.

You cut your finger or nick your leg and your body gets to work to stop the bleeding. You don’t give it a second thought. But what if this normal blood clotting process went into overdrive? That’s what happens with disseminated intravascular coagulation (DIC), a rare but serious condition.

With DIC, you get tiny blood clots throughout your bloodstream. The clumps can block small blood vessels and slow blood flow to organs. When your blood clots too often, substances that help with clotting can run out. If that happens, they won’t be there when your body truly needs them. That can cause severe bleeding anywhere from just beneath the skin to deep inside the body.

Another disease or condition such as an infection or injury is usually what causes DIC. The condition can develop over hours or days. Or it can happen more slowly over time. If DIC develops quickly, you need emergency care in a hospital.

DIC that develops over time may have no signs or symptoms. So it can be hard to spot. Heavy bleeding may be the first sign of sudden DIC.

Other signs and symptoms of DIC depend on what’s causing it. You may have these types of bleeding:

• Where you have cuts or wounds
• Where you had surgery, an IV needle, or a catheter
• In a bruise or in small red dots on the skin
• From your nose, gums, or mouth, including bleeding when you brush your teeth
• In your poop, which may appear dark red or tarlike
• In your urine
• With very heavy periods

You might have other serious problems, such as:

• Trouble breathing or shortness of breath
• Chest pain
• Headaches
• Low blood pressure
• Confusion, trouble speaking, dizziness, or seizures
• Pain, redness, swelling, and warmth in your lower legs

DIC might happen after you develop another disease or condition. These problems can increase your risk for DIC:

• Inflammation due to an illness, infection, or injury
• Tissue damage from a severe burn, frostbite, or major surgery
• Trauma such as a head injury
• Blood vessel problems such as an aneurysm
• Heat stroke
• Severe immune reaction
• Use of drugs such as cocaine or ecstasy
• Complications of childbirth
• Cancer

Certain cancers or problems during pregnancy may trigger proteins needed for clotting. The proteins may spring into action during pregnancy, for example, if the placenta separates from the uterus or if amniotic fluid enters the mother’s bloodstream.

A combination of a medical history, exam, and tests can help a doctor make a diagnosis.

Your doctor will ask questions about any recent illness, injury, or medical conditions you have so she can start to uncover the cause of your DIC. A physical exam may reveal signs and symptoms of these problems or of DIC such as bruising or bleeding.

To confirm a diagnosis of DIC, your doctor will order more than one type of blood test to look for blood clots and measure:

• How well your blood clots and how long it takes your blood to clot
• The number of red blood cells, platelets, and white blood cells you have
• How well your kidneys and liver are working
• Your sugar and electrolyte levels
• Levels of fibrinogen, a protein that is used when blood clots

To tell how severe DIC is, doctors often use a scoring system based on test results. You may have these tests more than once to track your condition over time. You may also need tests to rule out other problems and confirm the cause of your symptoms.

Treatment for DIC has two main goals: Control clotting and treat its cause. The type of treatment you receive depends on how severe your symptoms are.

When you get treatment for the underlying problem, the clotting should improve. But you may need other treatment as well, such as:

• Medicine in a pill or IV, including blood thinners to reduce blood clotting
• Oxygen therapy to get oxygen to your organs
• Platelet or plasma transfusion (these are blood components) to stop or prevent bleeding

If you have DIC, follow your doctor’s treatment plan and get regular follow-up care.

Be sure to:

• Take all medicine exactly as your doctor prescribes
• Follow through on treatment for the underlying condition
• Know when to return for office visits and blood tests
• Tell all your doctors if you are on blood thinners
• Call your doctor if you have new symptoms or if your existing symptoms get worse

Either overactive clotting or the bleeding that follows can cause complications that can threaten your life. These may include:

• Acute respiratory distress syndrome, a severe lung condition that leads to low levels of oxygen in your blood
• Heavy bleeding in your gut or elsewhere
• Heart attack or stroke
• Failure of more than one organ such as your lungs and kidneys
• Shock
• Blood clots in your lungs or in deep veins in your legs

Call 9-1-1 right away if you have signs or symptoms of:

• Heavy bleeding or chronic blood clots
• Heart attack or stroke
• Other severe complications