Disseminated intravascular coagulation (DIC) differs from thrombotic thrombocytopenic purpura. In this reference the DIC is most likely characterized by-
Ans. is 'c' i.e., Decreased coagulation factor levels DIC is characterized by excessive activation of the coagulation system. That leads to formation of microthrombi throughout the microcirculation of the body, often in a quixotically even distribution. o As a consequence of the thrombotic diathesis, there is consumption of platelets, fibrin and coagulation factors_and secondary activation of fibrinolytic mechanism. o Thus DIC can present with signs and symptoms relating to tissue hypoxia and infarction caused by the myriad microthrombi or as a hemorrhagic disorder related to depletion of elements required for homeostasis, hence the term consumption coagulopathy is used to describe D.I.C. o DIC can also lead to hemolytic anemia. It occurs due to fragmentation of red cells as they try to squeeze through the narrowed microvasculature. Schistocytes, the cells characteristic of microangiopathic hemolytic anemia are quiet common in patients with D. I.0 (seen in 50%) of cause. o Like D.I.C., TT.P too, is characterized by widespread thrombosis and similar to D.I.C, the disseminated thrombosis leads to microangiopathic hemolytic anemia. But the point to emphasize is that in TT.P the thrombus is a platelet thrombi i.e. the thrombi is composed mainly of platelets aggregates so quite unlike D.I.C. the level of coagulation factors remain normal. Robbins' States "While D.I.C. and thrombotic microangiopathies share features such as microvascular occlusion and microangiopathic hemolytic anemia, they are pathogenetically distinct. In T. and HUS (unlike DIC), activation of the coagulation cascade is not of primary impoant, and hence results of laboratory tests of coagulation such as PT and PTT are usually normal."
Significant numbers of schistocytes
A brisk reticulocytosis
Decreased coagulation factor levels
Significant thrombocytopenia