Methods for Differential Diagnosis of Consumption Coagulopathy

Abstract

In order to find out the sensitive tests to differentiate intravascular coagula tion from intravascular proteolysis, the changes in factors of coagulation fibrinolysis were studied on experimentally produced fibrinolysis, fibrinogenolysis and intravascular coagulation.Fibrinogen, and factors V and VIII were decreased; the prothrombin time, thrombin time and partial thromboplastin time were prolonged in both intravascular proteolysis and coagulation.The reliable factors to be tested for the differentiation were the prothrombin determined by the two stage method or by employing prothrombin-free plasma, plasminogen, platelets and the split products derived from either fibrinogen or fibrin. Namely, the platelets and prothrombin were decreased in intravascular coagulation, whereas these factors were normal in proteolytic stage. Plasminogen was low in both fibrinolytic and fibrinogenolytic states, but normal in intravascular coagulation. Basing on the facts that the split products from fibrinogenolysis were heat labile at 56°C for 15 minutes, while those from fibrinolysis were heat-stable, the differentiation between the split products from fibrinogen and fibrin was possible by measuring the thrombin clotting on a mixture of control plasma and heated or non-heated test sample, and by employing the simple radial immune diffusion technique.

Disseminated Intravascular Coagulation and Related Syndromes: A Clinical Review

“…By understanding the pathophysiologic aspects of DIC, it is quite clear that hemostasis will be consider ably altered and thus most common laboratory tests of hemostasis will be significantly abnormal. 76,[302][303][304] It is therefore useful to determine which tests are of practical significance with respect to providing a high degree of reliability as well as availability in assessing patients with DIC. In this regard, hospital laborato ries must be equipped to offer assays that will quickly and reliably allow assessment of patients with DIC.…”

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“…76,[302][303][304] It is therefore useful to determine which tests are of practical significance with respect to providing a high degree of reliability as well as availability in assessing patients with DIC. In this regard, hospital laborato ries must be equipped to offer assays that will quickly and reliably allow assessment of patients with DIC.…”