Document Detail


Laboratory testing in disseminated intravascular coagulation.
MedLine Citation:
PMID:  20614398     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The diagnosis of disseminated intravascular coagulation (DIC) relies on clinical signs and symptoms, identification of the underlying disease, the results of laboratory testing, and differentiation from other pathologies. The clinical features mainly depend on the underlying cause of the DIC. The laboratory diagnosis of DIC uses a combination of tests because no single test result alone can firmly establish or rule out the diagnosis. Global tests of hemostasis may initially provide evidence of coagulation activation and later in the process provide evidence of consumption of coagulation factors, but their individual diagnostic efficiency is limited. Fibrinolytic markers, in particular D-dimer, are reflective of activation of both coagulation and fibrinolysis, so that a normal finding can be useful for ruling-out DIC. Decreased levels of the natural anticoagulants (in particular, antithrombin and protein C) are frequently observed in patients with DIC, but their measurement is not normally incorporated into standard diagnostic algorithms. New tests are being explored for utility in DIC, and some additional tests may be useful on a case-by-case basis, depending on the proposed cause of the DIC or their local availability. For example, clot waveform analysis is useful but currently limited to a single instrument. Also, procalcitonin is an inflammatory biomarker that may be useful within the context of septic DIC, and activated factor X clotting time is an emerging test of procoagulant phospholipids that also seems to hold promise in DIC.
Authors:
Emmanuel J Favaloro
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Publication Detail:
Type:  Journal Article; Review     Date:  2010-07-07
Journal Detail:
Title:  Seminars in thrombosis and hemostasis     Volume:  36     ISSN:  1098-9064     ISO Abbreviation:  Semin. Thromb. Hemost.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-07-08     Completed Date:  2010-10-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0431155     Medline TA:  Semin Thromb Hemost     Country:  United States    
Other Details:
Languages:  eng     Pagination:  458-67     Citation Subset:  IM    
Copyright Information:
Copyright Thieme Medical Publishers.
Affiliation:
Department of Haematology, Institute of Clinical Pathology and Medical Research (ICPMR), Westmead Hospital, NSW, Australia. emmanuel.favaloro@swahs.health.nsw.gov.au
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MeSH Terms
Descriptor/Qualifier:
Blood Coagulation Tests
Disseminated Intravascular Coagulation / blood*,  diagnosis*,  pathology
Fibrinolysis
Hemostasis
Humans
Laboratory Techniques and Procedures

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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