Sepsis-associated disseminated intravascular coagulation and its differential diagnoses

Abstract

Disseminated intravascular coagulation (DIC) is a common complication in sepsis. Since DIC not only promotes organ dysfunction but also is a strong prognostic factor, its diagnosis at the earliest possible timing is important. Thrombocytopenia is often present in patients with DIC but can also occur in a number of other critical conditions. Of note, many of the rare thrombocytopenic diseases require prompt diagnoses and specific treatments. To differentiate these diseases correctly, the phenotypic expressions must be considered and the different disease pathophysiologies must be understood. There are three major players in the background characteristics of thrombocytopenia: platelets, the coagulation system, and vascular endothelial cells. For example, the activation of coagulation is at the core of the pathogenesis of sepsis-associated DIC, while platelet aggregation is the essential mechanism in thrombotic thrombocytopenic purpura and endothelial damage is the hallmark of hemolytic uremic syndrome. Though each of the three players is important in all thrombocytopenic diseases, one of the three dominant players typically establishes the individual features of each disease. In this review, we introduce the pathogeneses, symptoms, diagnostic measures, and recent therapeutic advances for the major diseases that should be immediately differentiated from DIC in sepsis.

Gap junctions regulate vessel diameter in chick chorioallantoic membrane vasculature by both tone‐dependent and structural mechanisms

“…the experimental setup provided here cannot mimic the complex conditions leading to sepsis, our data give in vivo evidence that break-down of gap junctional function results in microcirculatory changes similar to those seen in sepsis (malperfusion, hypoxia) and maybe even disseminated intravascular coagulation (stasis/ thrombosis) 46. F I G U R E 5 Co-incubation with DIP abolished CBX-induced vessel diameter decrease.…”

Evaluation of platelet count, erythrocyte sedimentation rate and C-reactive protein levels in paediatric patients with inflammatory and infectious disease

“…[ 18 ] reported that among children with bronchiolitis, elevation in platelet count (thrombocytosis) is a common presentation; however, it is not associated with disease severity or complications. On the contrary, sepsis is also defined as a critical thrombocytopenic disease in a number of studies [ 19 ]. Imani-Rastabi et al.…”

The pathophysiology of SARS-CoV-2: A suggested model and therapeutic approach

“…P-selectin also plays an important role in increasing neutrophil binding to ECs, thereby increasing neutrophil rolling while increasing expression of MAC-1 in PNCs, which increases neutrophil tethering and subsequent crawling [ 125 , 126 ]. There are other receptors involved in the process and readers interested in a more detailed consideration of this topic are referred to excellent reviews by [ 127 , 128 ].…”