It is DIC...Don't let Labs Mislead you

When you put DIC in the Differential list,be careful when you read the lab results,misleading may occur because of the following reasons:

1-Thrombocytopenia (<100,00/uL) is not always evident early in the process, but true DIC without sequential reduction in platelet count is very unlikely.

2-PT and aPTT may remain normal in spite of decreasing factor levels because of the presence of high levels of activated

factors including thrombin and Xa.

3-Fibrinogen level may not be decreased, i.e., <100 mg/dL, initially. Fibrinogen is an “acute phase reactant” which increases in response to stress and the early consumption of fibrinogen may simply reduce its levels to “normal”.

4-FDPs are a sensitive measure of fibrinolytic activity although they not specific for DIC.

5-D-dimer (which is a breakdown product of the cross-linked fibrin in a mature clot) is somewhat morespecific for DIC.

ASA refresher courses 2009