Disseminated Intravascular Coagulation (DIC): Symptoms, Causes, and Treatment

Bleeding, sometimes from multiple locations on the body, is one of the more common symptoms of DIC. Bleeding from the mucosal tissue (in the mouth and nose) and other external areas may occur. In addition, DIC may cause internal bleeding.

Other signs and symptoms of DIC may include:

• blood clots, which may cause pain, swelling, and redness in the skin
• pain, swelling, and warmth in your lower legs
• low blood pressure (hypotension), which is considered a reading of 90/60 mm Hg or lower
• easy bruising, which may appear as small red or purple dots (petechiae) or clusters of large patches (purpura)
• bloody stools, which may appear tarry and black from bleeding in your stomach or intestines
• blood in your urine
• unusually heavy menstrual bleeding
• bleeding from urinary catheter use
• bleeding easily from wounds or after surgery
• hematomas, which are larger bruises that also cause swelling and pain
• frequent nosebleeds
• bleeding from your gums, especially after brushing your teeth or flossing
• yellowing of the skin or eyes (jaundice), which could indicate liver problems
• shortness of breath
• chest pain
• headaches
• dizziness or confusion
• seizures

If you have cancer, DIC generally begins slowly, and clotting in the veins is more common than excessive bleeding. At first, cancer-related DIC may not cause any symptoms at all.

When the proteins used in your normal clotting process become overly active, it can cause DIC.

Conditions that are known to contribute to DIC include:

• infections, such as sepsis
• severe physical trauma (such as brain injuries or crushing injuries)
• inflammation
• surgery
• cancer

Some less common causes of DIC can include the following:

• extremely low body temperature (hypothermia)
• venomous snake bites
• pancreatitis
• burns
• complications during pregnancy
• severe infectious diseases, including severe COVID-19 pneumonia
• tumors and very low blood platelet count due to diseases like cancer
• trauma
• immune system reactions, such as to blood transfusions
• heat stroke

You may also develop DIC if you go into shock.

Your risk of DIC may be higher if you have recently:

• undergone surgery
• delivered a baby
• had an incomplete miscarriage
• had a blood transfusion
• had general anesthesia
• had sepsis or any other fungal or bacterial blood infection
• had certain types of cancer, especially certain types of leukemia
• had serious tissue damage such as burns, trauma, or a head injury
• had liver disease

Since DIC isn’t a condition that is regularly screened for at your annual exam, it’s important to be aware of the possible symptoms, particularly if you have any risk factors for this condition.

If a doctor considers you at a higher risk of developing DIC, they may order blood tests, such as a complete blood cell count (CBC) that checks your platelets, red blood cell numbers, and provides other important information about your blood. Your doctor may routinely check your blood if you’re at a high risk.

Unfortunately, not all cases of DIC may be prevented. Examples include unexpected injuries and acute medical conditions.

DIC may be identified through various tests related to your levels of platelets, clotting factors, and other blood components. However, there isn’t a standard procedure.

The following are some tests that may be conducted if your doctor suspects DIC:

• CBC. This test measures platelets as well as red and white blood cells.
• CBC smear. A CBC smear looks at the size and shape of your blood cells, including mean platelet volume (MPV).
• Tests on your blood’s ability to clot. Partial thromboplastin time and prothrombin time tests both help determine how long it takes for your blood to clot.
• D-dimer test. The D-dimer test looks for blood clots. A higher level can be associated with DIC.
• Serum fibrinogen test. This test measures low fibrinogen proteins that may indicate DIC.
• Measures of clot-dissolving substances in your blood. Elevated results on a test to examine fibrin degradation products could indicate DIC.
• Metabolic panel. A metabolic panel can look for possible kidney and liver damage caused by DIC.

In addition to blood testing, a doctor may also perform a physical exam to check for visible signs of bleeding or blood clots. They may also ask if you’ve had any recent surgeries, injuries, or medical problems.

DIC can cause complications, especially when it isn’t treated properly. Complications can occur from both the excessive clotting that happens in the early stages of the condition and the absence of clotting factors in the later stages. Complications may include:

• heart attack
• stroke
• failure of vital organs, such as your liver or kidneys
• bleeding in your gastrointestinal (GI) tract
• excessive bleeding (hemorrhage) that may lead to death
• shock
• acute respiratory distress syndrome (ARDS), which develops from low blood oxygen to your lungs
• blood clots in your lungs (pulmonary embolism)
• blood clots in your legs (deep vein thrombosis)
• death

DIC treatment depends on what is causing the disorder. Treatment of the underlying cause is the main goal.

To treat the clotting problem, you may be given an anticoagulant called heparin to reduce and prevent clotting. However, heparin may not be administered if you have a severe lack of platelets or are bleeding too excessively.

People with acute (sudden) DIC require hospitalization, often in an intensive care unit (ICU). There, treatment will attempt to correct the problem causing DIC while maintaining the function of the organs.

A transfusion may be needed to replace the missing platelets. Plasma transfusions have the ability to replace the clotting factors.

The outlook of your treatment depends on what caused you to develop DIC. If the initial problem can be corrected, then DIC will resolve. If not, your doctor may prescribe blood thinners to prevent blood clots.

People who are taking blood thinners should see their doctor for regular checkups. Your doctor will want to give you regular blood tests to evaluate how your blood is clotting.

DIC is a serious, potentially life threatening condition that leads to excessive blood clots. It may be brought on by acute illnesses or injuries, as well as long-term (chronic) conditions such as cancer.

When detected early, DIC is treatable. It’s also important to follow your treatment plan for any underlying conditions that may be contributing to DIC and to see a doctor for regular blood testing.

See a doctor right away if you think you’re experiencing possible symptoms of DIC. Seek emergency medical help for uncontrolled bleeding, stroke, and other more serious complications.