Disseminated intravascular coagulation (DIC) occurs secondary to a variety of far ranging disorders including severe trauma, infection, malignancies (especially leukemia in the pediatric population), severe snakebite reaction, and vascular lesions (kaposiform hemangioendotheliomas, tufted angiomas). The Kasabach-Merritt syndrome is a particular form of DIC where there is consumption of platelets and clotting factors within a kaposiform hemangioendothelioma or tufted angioma.
DIC occurs when there is intravenous coagulation in association with consumption of platelets. Hemolytic anemia and thromboembolism secondary to intravascular coagulation occurs.
The symptoms of DIC can be mild to severe. The onset can be subacute or sudden with associated high fever and development of purpura.
In severe cases, fatality can occur within 2 days.
Potentially life-threatening emergency
Disseminated intravascular coagulation in Child
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Synopsis
Codes
ICD10CM:
D65 – Disseminated intravascular coagulation [defibrination syndrome]
SNOMEDCT:
67406007 – Disseminated intravascular coagulation
D65 – Disseminated intravascular coagulation [defibrination syndrome]
SNOMEDCT:
67406007 – Disseminated intravascular coagulation
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Coumadin (warfarin) necrosis
- Heparin necrosis
- Recluse spider envenoming
- Acute meningococcemia
- Necrotizing fasciitis
- Large vessel vasculitis
- Thrombotic thrombocytopenic purpura
- Idiopathic purpura fulminans
- Localized trauma
- Primary bone marrow failure – such as an infiltrative process or leukemia
- Primary fibrinolysis
- Coagulation factor deficiency syndrome
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
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References
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Last Reviewed:02/15/2017
Last Updated:02/15/2017
Last Updated:02/15/2017
Potentially life-threatening emergency
Disseminated intravascular coagulation in Child