What is Disseminated Intravascular Coagulation (DIC)?
DIC is a life-threatening condition where your blood's clotting system goes haywire throughout your entire body—it starts forming tiny blood clots everywhere while simultaneously causing dangerous bleeding because it uses up all your clotting materials. 1
Understanding the Basics
Think of your blood clotting system like a fire department that should only respond to specific emergencies (cuts or injuries). In DIC, it's as if someone pulled all the fire alarms at once across the entire city—the system activates everywhere at the same time when it shouldn't. 1
What Happens in Your Body
Widespread clotting activation: Your blood starts forming tiny clots in small blood vessels throughout your body, blocking blood flow to vital organs like your kidneys, lungs, liver, and brain. 2, 3
Paradoxical bleeding: While clots are forming, your body simultaneously runs out of the materials needed to clot (like platelets and clotting proteins), which means you can start bleeding uncontrollably from multiple sites—your gums, nose, injection sites, or internally. 2, 4
Organ damage: The tiny clots block blood flow to organs, potentially causing them to fail, while the bleeding can be life-threatening. 1, 3
What Causes This to Happen
DIC never occurs on its own—it's always triggered by another serious medical condition. 5, 4
Common Triggers
Severe infections (sepsis): The most common cause, where bacteria or their toxins in your bloodstream trigger the clotting system. In septic patients with DIC, mortality reaches 24.8%. 1, 6
Cancer: Particularly pancreatic cancer and certain leukemias, which release substances that activate clotting. 6, 5
Major trauma or surgery: Severe injuries or complicated operations can trigger widespread clotting activation. 5, 7
Pregnancy complications: Certain obstetric emergencies can cause DIC. 2, 3
Severe liver failure: The liver normally controls clotting balance, and when it fails, this system can spiral out of control. 6
How It Presents
Bleeding Type (Hyperfibrinolytic DIC)
- Widespread bruising appearing spontaneously across your body 5
- Bleeding from your mouth, nose, or other mucous membranes 5
- Bleeding from IV sites or surgical wounds that won't stop 5
- Internal bleeding in your brain, lungs, or digestive system 5
Clotting Type (Procoagulant DIC)
- Poor circulation to fingers and toes (they may turn blue or purple) 5
- Stroke-like symptoms from brain clots 5
- Chest pain or difficulty breathing from lung clots 5
- Severe abdominal pain from intestinal clots 5
Silent Type (Subclinical DIC)
- No obvious symptoms, but blood tests show the system is activated 5
- May progress to either bleeding or clotting complications 5
The Underlying Mechanism
The key problem is that your blood vessel lining (endothelium) gets damaged, which sets off a chain reaction. 1
- Damaged blood vessels release signals that activate your clotting system everywhere instead of just at injury sites 1, 6
- Your body's natural "brakes" on clotting (proteins like antithrombin and protein C) get overwhelmed and depleted 6
- Inflammation from the underlying disease (like sepsis) keeps fueling this vicious cycle 6
Why This Matters
- High mortality: DIC is a medical emergency with death rates approaching 25% even with treatment, depending on the underlying cause 1
- Organ failure: The combination of clotting blocking blood flow and bleeding depleting oxygen delivery can cause multiple organs to fail 1, 3
- Requires urgent treatment: Both the underlying disease and the DIC itself need immediate medical attention 3, 4
The Bottom Line
DIC is essentially your body's clotting system being activated everywhere at once by a serious underlying illness, creating a dangerous situation where you're simultaneously forming harmful clots throughout your body while also bleeding because you've exhausted your clotting resources. It's always a sign of a severe underlying medical problem that needs emergency treatment. 1, 4