ISTH Scoring System for Disseminated Intravascular Coagulation (DIC)

Platelet count:

 • Expected: Low (or normal)

 • Elevation in thrombin → thrormbin-induced platelet aggregation

PT, aPTT:

 • Expected: Elevated

 • Decreases due to consumption of coagulation factors, Can be normal since the presence of thrombin and factor Xa can accelerate thrombin formation, DO NOT monitor using INR use PT

D-dimer:

 • Expected: Elevated

 • Elevated as this is a product of fibrinolysis

Fibrinogen:

 • Expected: Low (or normal)

 • Is broken down by thrombin to form clots, Can be normal as fibrinogen is also an acute-phase reactant

Blood smear:

 • Expected: Schistocytes

 • Intra-luminal deposition of fibrin leads to shearing of RBCs as they pass through small vessels



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