Vascular Disease Vascular Disease Basics

Tracking a Mysterious Blood Disorder to Keep Serious Diseases Under Control

It's not a disorder that many doctors will ever see, making it hard to spot those who suffer disseminated intravascular coagulation (DIC). But if left unrecognized, DIC can prove deadly. Newly released medical records suggest that DIC may be one of the possibilities for why Yasser Arafat, the former Palestine leader, passed away last November.

DIC is a rare blood disorder caused by abnormal clotting. With DIC, the platelets that aid clotting are depleted, prompting blood to ooze out in the parts of the body that are damaged. Eventually, DIC can lead to organ failure and death. It is not a disease in itself, however. DIC is always associated with an underlying disorder, and it can remain relatively mild for some time.

"It's unusual to see it out of the blue," says Dr. Thomas DeLoughery, a critical care specialist at Oregon Health & Science University in Portland. Still, DIC can quickly become life threatening on its own, especially if the original condition is not properly controlled.

What conditions are linked to DIC?
Sepsis and other bacterial infections are a major culprit, as well as infections caused by viruses and parasites. Severe physical traumas, such as an aneurysm or injury to the brain, are also frequently associated with this disorder, as is a reaction to a snake bite. Both solid tumors and cancers of the blood may be made more dangerous by DIC. DeLoughery says that infections and cancer are the most common conditions associated with the disease.

What are the symptoms of DIC?
Bleeding for no clear reason is a major sign of DIC, as well as blood that clots either too much or too little. Such symptoms—the bleeding may be internal—may not always be apparent to patients. But if you have an underlying condition that is associated with DIC, and you notice that your gums bleed after brushing your teeth, this may be a warning, DeLoughery says.

How is DIC diagnosed?
There is no single test that can tell if you have DIC for certain, notes Dr. Marci Levi, a leading expert from the University of Amsterdam. "It can be confusing," adds DeLoughery.

In the journal Critical Care Clinician, Levi outlines the steps needed to diagnose DIC. If the patient has one of the underlying conditions associated with the condition, doctors should run a series of blood tests and add up such things as platelet counts or clotting times. In the end, however, it is still up to a doctor to make a judgment call.

How is DIC treated?
The best way to treat DIC is to attack the true cause, such as the infection or other problem. If there is no serious bleeding or an unusual risk for any, it is usually appropriate to observe patients rather than treat DIC. In some cases, Levi notes, the disease may clear up within hours of treating the underlying condition.

For more serious cases, DeLoughery says it may be necessary to give blood clotting substitutes until the disease that causes DIC is brought under control. "We give support until we can find something for the underlying disease," he says. By being aware of the conditions where DIC can crop up, DeLoughery says that it is often possible to diagnose and treat the condition effectively.