Acute DIC and organ damage

Q: Which of the following organ is most vulnerable during an episode of acute Disseminated intravascular coagulation (DIC)?

A) Kidney
B) Liver
C) Lungs
D) Brain
E) Adrenals


Answer: A

In real-world there is no organ that is immune from acute DIC, but renal function tends to get the most damage. About 40-50 percent of patients develop some sort of renal failure. It is followed by the liver. Pulmonary damage is mostly manifested by hemoptysis, and underlying microthrombi eventually leading to acute respiratory distress syndrome (ARDS). Neurologic complications may occur as well. Adrenals require close watch as Waterhouse-Friderichsen syndrome may occur due to adrenal hemorrhage or infarction.

#hematology


References:

1. Ohashi R, Hosokawa Y, Kimura G, Kondo Y, Tanaka K, Tsuchiya S. Acute renal failure as the presenting sign of disseminated intravascular coagulation in a patient with metastatic prostate cancer. Int J Nephrol Renovasc Dis. 2013;6:47-51. doi:10.2147/IJNRD.S41813 

2.  Dominic SC; Somiah S; Srinivas; Sheeba SD; Swapna Acute renal failure in disseminated intravascular coagulation. Indian Journal of Nephrology. 1995 Apr-Jun; 5(2): 47-9 

3. Siegal T, Seligsohn U, Aghai E, Modan M. Clinical and laboratory aspects of disseminated intravascular coagulation (DIC): a study of 118 cases. Thromb Haemost 1978; 39:122.