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April 16, 1982

Disseminated Intravascular Coagulation in Hypothermia

JAMA. 1982;247(15):2099. doi:10.1001/jama.1982.03320400019019

To the Editor.—  We noted the article by Mahajan et al (1981;246:2517) describing disseminated intravascular coagulation (DIC) in hypothermia. The hematologic workup identifying hypothermia as the primary cause of the DIC was thorough and well documented.However, the association of DIC with hypothermia has been well recognized in the past. Rueler1 reviewed the subject of hypothermia and pointed out that DIC was a known hematologic complication. Stine2 reviewed the subject and discussed the complication of intravascular thrombosis. Duguid et al3 recorded hemorrhagic and thrombotic lesions in the brain, spleen, heart, kidney, and gut during postmortem examination of patients who died of hypothermia.A more recent study4 evaluated 11 cases of accidental hypothermia and found that seven patients had platelet counts of less than 150,000/cu mm. Furthermore, two of these patients had serum fibrinogen levels of less than 150 mg/dL (normal, >200 mg/ dL) and died of