Etiopathophysiology of disseminated intravascular coagulation.
Disseminated intravascular coagulation (DIC) involves activation of clotting as well as fibrinolytic pathways. Thrombosis from thrombin release results in end-organ damage, whereas consumption of coagulation factors results in bleeding. Sepsis is the commonest cause of DIC. The consumption of antithrombin in sepsis abrogates its anti-inflammatory role and so its low level is a poor prognostic marker in sepsis. The increased release of plasminogen activator inhibitor-1 (PAI-1) as seen in sepsis decreases fibrinolysis and promotes increased microvascular thrombosis. Here, we discuss the role of inhibitors of coagulation, cytokines, kinins, complement and vasoactive peptides in DIC.
Bakhshi
S
S
Department of Pediatrics, Division of Hematology Oncology, All India Institute of Medical Sciences, New Delhi 110 029.
Arya
L S
LS
D001777:Blood Coagulation / Q000502:physiology; D016207:Cytokines / Q000378:metabolism; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology*; D005260:Female; D005342:Fibrinolysis / Q000502:physiology; D005831:Genital Diseases, Female / Q000150:complications; D006801:Humans; D007239:Infections / Q000150:complications*; D012307:Risk Factors; D014652:Vascular Diseases / Q000150:complications; D014947:Wounds and Injuries / Q000150:complications
D016207:Cytokines