Disseminated intravascular coagulation (DIC) presents with simultaneous thrombosis and haemorrhage. Which laboratory profile is MOST consistent with acute DIC?

• A Normal PT, isolated aPTT prolongation, low FVIII:C, and normal platelet count
• B Elevated fibrinogen, normal D-dimer, normal platelet count, and isolated PT prolongation
• C Prolonged PT and aPTT, low fibrinogen, elevated D-dimer, thrombocytopenia, and positive MAHA on smear ✓
• D Thrombocytopenia with normal PT/aPTT, low ADAMTS13, and elevated LDH

Explanation

Acute DIC is characterised by consumption of clotting factors (prolonged PT and aPTT), consumption of fibrinogen (hypofibrinogenaemia < 100 mg/dL), thrombocytopenia from platelet consumption in microthrombi, elevated D-dimer and FDP from secondary fibrinolysis, and microangiopathic haemolytic anaemia (schistocytes on smear) from red cell shearing in fibrin-occluded microvasculature. Normal fibrinogen and D-dimer exclude DIC; isolated aPTT prolongation suggests haemophilia.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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