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January 13, 1975

Disseminated Intravascular Coagulation —A Color of Different Horses

JAMA. 1975;231(2):180-181. doi:10.1001/jama.1975.03240140040026

Disease complications generally fall into one of two categories. They may be unrelated diseases caused by organisms invading a host whose resistance had been undermined. Thus, otitis media or pneumonia may complicate measles. Alternatively, they may be unsurprising adverse developments in a severe disease of a specific organ. Such a complication is hepatic coma in hepatic cirrhosis, or uremia in chronic renal disease.

A complication that does not quite fit either of the two categories is disseminated intravascular coagulation (DIC). It is neither a secondary infection, nor a predictable outcome of a specific organ disease. More often than not it is an unexpected development in a wide variety of conditions. Its hallmark is the paradoxical coexistence of thrombosis and hemorrhage. The former is initiated by thromboplastic substances, damaged platelets, injured vascular endothelium, and other as yet unidentified mechanisms that activate clotting. As a consequence of the widespread clotting, there is