From the Guidelines
Typical laboratory findings in Disseminated Intravascular Coagulation (DIC) include thrombocytopenia, prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT), decreased fibrinogen levels, and elevated D-dimer levels, as recommended by the International Society on Thrombosis and Haemostasis (ISTH) overt DIC criteria 1. These abnormalities reflect the simultaneous excessive clotting and bleeding that characterize DIC.
- Key laboratory findings include:
- Thrombocytopenia (low platelet count)
- Prolonged PT and aPTT
- Decreased fibrinogen levels
- Elevated D-dimer levels Additional findings often include elevated fibrin degradation products (FDPs), decreased antithrombin III levels, and the presence of schistocytes (fragmented red blood cells) on peripheral blood smear. Serial laboratory testing is essential for diagnosis and monitoring, as values may change rapidly, and the severity of these abnormalities generally correlates with the severity of DIC, with more pronounced changes indicating more severe disease, as noted in the management of massive blood loss 1. The ISTH overt DIC criteria, which include laboratory markers such as platelet count, PT ratio, fibrin/fibrinogen degradation products (FDP), fibrinogen, and D-dimer, are widely used for diagnosis, and early recognition of these laboratory patterns is crucial for prompt diagnosis and management of the underlying cause of DIC 1.
From the Research
Lab Findings for Disseminated Intravascular Coagulation (DIC)
The typical lab findings for DIC include:
- Decrease in platelet count 2, 3, 4, 5, 6
- Prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT) 2, 3, 4, 5
- Decrease in fibrinogen 2, 3, 4, 5, 6
- Increase in fibrin/fibrinogen degradation products (FDP) and D-dimer 2, 3, 4, 5, 6
- Increase in coagulation activation marker thrombin-antithrombin complex (TAT) and fibrinolysis activation marker plasmin-α2 plasmin inhibitor (PIC) 6
- Decrease in α2 plasmin inhibitor (α2PI) 6
Diagnostic Tests for DIC
The following tests are used to diagnose DIC:
- Prothrombin time (PT) 2, 3, 4, 5
- Partial thromboplastin time (PTT) 2, 3, 4, 5
- Fibrinogen/fibrin degradation products (FDP) 2, 3, 4, 5
- D-dimer 2, 3, 4, 5, 6
- Platelet count 2, 3, 4, 5, 6
- Antithrombin 4
Sensitivity and Specificity of Diagnostic Tests
The sensitivity and specificity of the diagnostic tests for DIC are: