Disseminated intravascular coagulation classification
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Differentiating Disseminated intravascular coagulation from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omer Kamal, M.D.[2]
Overview
There is no established system for the classification of [disease name].
OR
[Disease name] may be classified according to [classification method] into [number] subtypes/groups: [group1], [group2], [group3], and [group4].
OR
[Disease name] may be classified into [large number > 6] subtypes based on [classification method 1], [classification method 2], and [classification method 3]. [Disease name] may be classified into several subtypes based on [classification method 1], [classification method 2], and [classification method 3].
OR
Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.
OR
If the staging system involves specific and characteristic findings and features: According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].
OR
The staging of [malignancy name] is based on the [staging system].
OR
There is no established system for the staging of [malignancy name].
Classification
Disseminated intravascular coagulation may be classified according to the degree of fibrinolytic activation into the following subtypes/groups[1]:
Suppressed-fibrinolytic-type DIC (DIC with suppressed fibrinolysis) [2][3][4][5]
- Severe coagulation activation
- Mild fibrinolytic activation
- Seen in sepsis mostly
- Mild bleeding complications
- Elevated thrombin-antithrombin complex (TAT) , a coagulation activation marker
- Mildy elevated plasmin-α2 plasmin inhibitor complex (PIC), a fibrinolysis activation marker
- Mildly elevated Fibrin/fibrinogen degradation products (FDPs) and D-dimers
- Normal or only slightly decreased α2 plasmin inhibitor (α2PI)
Enhanced-fibrinolytic-type DIC (DIC with enhanced fibrinolysis)[2][3][4][5]
- Presents with marked fibrinolysis activation corresponding to coagulation activation
- Strong activation of fibrinolysis
- with hardly any elevation in PAI
- Severe bleeding severe.
- Elevation in both TAT and PIC
- Elevated FDPs and D-dimer
- FDP/D-dimer ratio tends to increase (decrease when expressed as the D-dimer/FDP ratio).
- Associated with APL, abdominal aortic aneurysm, and prostate cancer.
Balanced-fibrinolytic-type DIC (DIC with balanced fibrinolysis) [2][3][4][5]
- Presents a balance between coagulation activation and fibrinolytic activation
- Relatively uncommon bleeding and organ symptoms
- Seen in solid cancers
References
- ↑ Asakura H (2014). "Classifying types of disseminated intravascular coagulation: clinical and animal models". J Intensive Care. 2 (1): 20. doi:10.1186/2052-0492-2-20. PMC 4267600. PMID 25520834.
- ↑ 2.0 2.1 2.2 Asakura H, Ontachi Y, Mizutani T, Kato M, Saito M, Kumabashiri I, Morishita E, Yamazaki M, Aoshima K, Nakao S (June 2001). "An enhanced fibrinolysis prevents the development of multiple organ failure in disseminated intravascular coagulation in spite of much activation of blood coagulation". Crit. Care Med. 29 (6): 1164–8. PMID 11395595.
- ↑ 3.0 3.1 3.2 Takahashi H, Tatewaki W, Wada K, Hanano M, Shibata A (February 1990). "Thrombin vs. plasmin generation in disseminated intravascular coagulation associated with various underlying disorders". Am. J. Hematol. 33 (2): 90–5. PMID 1689102.
- ↑ 4.0 4.1 4.2 Asakura H, Jokaji H, Saito M, Uotani C, Kumabashiri I, Morishita E, Yamazaki M, Aoshima K, Matsuda T (October 1994). "Study of the balance between coagulation and fibrinolysis in disseminated intravascular coagulation using molecular markers". Blood Coagul. Fibrinolysis. 5 (5): 829–32. PMID 7865691.
- ↑ 5.0 5.1 5.2 Asakura H, Jokaji H, Saito M, Uotani C, Kumabashiri I, Morishita E, Yamazaki M, Matsuda T (March 1991). "Changes in plasma levels of tissue-plasminogen activator/inhibitor complex and active plasminogen activator inhibitor in patients with disseminated intravascular coagulation". Am. J. Hematol. 36 (3): 176–83. PMID 1899963.