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Disseminated intravascular coagulation in autopsy cases. Its incidence and clinicopathologic significance

T Watanabe, T Imamura, K Nakagaki

    Pathology, Research and Practice
    |November 1, 1979
    PubMed

    Insights

    Disseminated intravascular coagulation (DIC) is often missed clinically, with microthrombi found in over 74% of autopsy cases. Autopsy findings are crucial for diagnosing this frequent, often fatal condition.

    Area of Science:

    • Pathology
    • Internal Medicine
    • Medical Diagnosis

    Background:

    • Disseminated intravascular coagulation (DIC) is a complex pathophysiological state complicating various medical conditions.
    • Clinical diagnosis of DIC can be challenging, potentially leading to underestimation of its prevalence.
    • Autopsy studies provide valuable insights into the true incidence and histopathological features of DIC.

    Purpose of the Study:

    • To determine the frequency and histopathological characteristics of disseminated intravascular coagulation (DIC) in a large autopsy cohort.
    • To assess the clinical suspicion of DIC in cases diagnosed post-mortem.
    • To identify common underlying causes and affected organs in DIC.

    Main Methods:

    • Histopathological examination of 1729 consecutive autopsies.
    • Diagnosis of DIC based on the presence of microthrombi in multiple organs.
    • Correlation of autopsy findings with clinical suspicion and underlying diseases.

    Main Results:

    • Disseminated intravascular coagulation (DIC) was diagnosed in 51 (2.95%) of 1729 autopsies.
    • In 74.5% of these cases, DIC was not clinically suspected.
    • Microthrombi were most frequently observed in kidneys, lungs, spleen, and adrenals.
    • Kidney lesions, including acute tubular necrosis and renal cortical necrosis, were prominent.
    • Common underlying causes included infections (often with shock) and malignancies.

    Conclusions:

    • Disseminated intravascular coagulation (DIC) is a frequent and often fatal complication that is frequently missed clinically.
    • Autopsy-based histopathological evidence of microthrombi and visceral alterations is critical for accurate DIC diagnosis.
    • Recognizing DIC's histopathological hallmarks is essential for evaluating suspected cases and understanding its impact.

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