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2018 ; 16
(ä): 14
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Differences and similarities between disseminated intravascular coagulation and
thrombotic microangiopathy
#MMPMID30008620
Wada H
; Matsumoto T
; Suzuki K
; Imai H
; Katayama N
; Iba T
; Matsumoto M
Thromb J
2018[]; 16
(ä): 14
PMID30008620
show ga
INTRODUCTION: Both disseminated intravascular coagulation (DIC) and thrombotic
microangiopathy (TMA) cause microvascular thrombosis associated with
thrombocytopenia, bleeding tendency and organ failure. REPORTS AND DISCUSSION:
The frequency of DIC is higher than that of thrombotic thrombocytopenic purpura
(TTP). Many patients with TMA are diagnosed with DIC, but only about 15% of DIC
patients are diagnosed with TMA. Hyperfibrinolysis is observed in most patients
with DIC, and microangiopathic hemolytic anemia is observed in most patients with
TMA. Markedly decreased ADAMTS13 activity, the presence of Shiga-toxin-producing
Escherichia coli (STEC) and abnormality of the complement system are useful for
the diagnosis of TTP, STEC-hemolytic uremic syndrome (HUS)and atypical HUS,
respectively. However, there are no specific biomarkers for the diagnosis of DIC.
CONCLUSION: Although DIC and TMA are similar appearances, all coagulation,
fibrinolysis and platelet systems are activated in DIC, and only platelets are
markedly activated in TMA.