[DIC: state-of-the-art in diagnosis and management]

Area of Science:

• Hematology
• Pathophysiology
• Diagnostic Criteria

Background:

• Disseminated intravascular coagulation (DIC) is a critical condition characterized by systemic coagulation activation and microthrombi formation.
• Differentiating DIC from thrombotic microangiopathy (TMA) can be challenging due to overlapping clinical and laboratory features.
• Traditional coagulation tests like PT and APTT have limitations in definitively distinguishing between DIC and TMA.

Purpose of the Study:

• To introduce and discuss the revised diagnostic criteria for DIC established by the Japanese Society on Thrombosis and Hemostasis (2017).
• To highlight the importance of classifying DIC types for understanding pathophysiology and guiding treatment strategies.
• To explore the role of genetic analysis in understanding DIC development, focusing on the protein C/thrombomodulin system and plasminogen activator inhibitor.

Main Methods:

• Review and analysis of the new DIC diagnostic criteria (2017 edition).
• Discussion of the role of tissue factor in DIC pathogenesis.
• Examination of genetic factors, including the protein C/thrombomodulin system and plasminogen activator inhibitor, in DIC control and development.

Main Results:

• New diagnostic criteria for DIC have been established, revising previous standards.
• Tissue factor is identified as a key factor in the common mechanisms of DIC development across various underlying diseases.
• The protein C/thrombomodulin system and plasminogen activator inhibitor are crucial in DIC regulation and progression, as indicated by genetic analyses.

Conclusions:

• The revised 2017 DIC diagnostic criteria are expected to significantly impact future DIC diagnosis.
• Accurate classification of DIC is essential for effective treatment planning.
• Genetic insights into specific regulatory systems offer a deeper understanding of DIC pathophysiology.