Which laboratory findings are characteristic of DIC?

Which laboratory findings are characteristic of DIC?

• A. Decreased platelets (<100,000), increased PT and PTT, decreased fibrinogen (<200 mg), and increased FDP or D-dimer.
• B. Increased platelets, shortened PT and PTT, increased fibrinogen, and decreased D-dimer.
• C. Decreased platelets, prolonged PT and PTT, decreased fibrinogen, and elevated FDP or D-dimer.
• D. Normal platelets, normal PT/PTT, normal fibrinogen, and normal D-dimer.

Answer: (C)

Disseminated intravascular coagulation presents as a consumption coagulopathy: the body’s clotting system is activated all over, using up platelets and clotting factors while also breaking down clots. This produces a lab pattern of thrombocytopenia, prolonged clotting times (PT and aPTT), and consumption of fibrinogen, so fibrinogen levels fall. At the same time, widespread clot formation followed by fibrinolysis raises fibrin degradation products, including an elevated D-dimer. So the combination of low platelets, prolonged PT/PTT, low fibrinogen, and high fibrin degradation products (FDPs or D-dimer) best fits DIC. Normal findings or opposite trends (normal labs, increased platelets, shortened PT/PTT, or high fibrinogen) do not describe DIC.

Disseminated intravascular coagulation presents as a consumption coagulopathy: the body’s clotting system is activated all over, using up platelets and clotting factors while also breaking down clots. This produces a lab pattern of thrombocytopenia, prolonged clotting times (PT and aPTT), and consumption of fibrinogen, so fibrinogen levels fall. At the same time, widespread clot formation followed by fibrinolysis raises fibrin degradation products, including an elevated D-dimer. So the combination of low platelets, prolonged PT/PTT, low fibrinogen, and high fibrin degradation products (FDPs or D-dimer) best fits DIC. Normal findings or opposite trends (normal labs, increased platelets, shortened PT/PTT, or high fibrinogen) do not describe DIC.