In disseminated intravascular coagulation (DIC), both bleeding and thrombosis occur simultaneously. Which of the following laboratory patterns is characteristic of consumptive coagulopathy in DIC?

• A Elevated fibrinogen, low D-dimer, normal PT and aPTT
• B Normal fibrinogen, isolated thrombocytopenia with normal PT/aPTT
• C Elevated fibrinogen with markedly elevated platelet count and normal PT
• D Low fibrinogen, elevated D-dimer, prolonged PT and aPTT, thrombocytopenia ✓

Explanation

DIC causes widespread activation of coagulation, consuming clotting factors and platelets (thrombocytopenia) while fibrinolysis generates D-dimers (fibrin degradation products). Fibrinogen is consumed (hypofibrinogenemia), PT and aPTT are prolonged due to factor depletion, and D-dimer is markedly elevated reflecting fibrin formation and lysis. This pattern distinguishes DIC from liver disease (where factor levels are low but D-dimer may be less elevated and platelets are less consumed) and from simple thrombocytopenia.

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

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