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Abnormal bleeding in the absence of a known hematologic disorder suggests DIC. Initial laboratory findings supporting a tentative diagnosis of DIC include:
❑ prolonged prothrombin time (PT): greater than 15 seconds
❑ prolonged partial thromboplastin time (PTT): greater than 60 to 80 seconds
❑ decreased fibrinogen levels: less than 150 mg/dl
❑ decreased platelet count: less than 100,000/µl
❑ increased fibrin degradation products: commonly greater than 100 µg/ml.
❑ positive d-dimer test: specific for DIC; test is positive at less than ⅛ dilution
Other supportive data include positive fibrin monomers, diminished levels of factors V and VIII, fragmentation of red blood cells (RBCs), and decreased hemoglobin (less than 10 g/dl). Assessment of renal status demonstrates a reduction in urine output (less than 30 ml/hour) and elevated blood urea nitrogen (greater than 25 mg/dl) and serum creatinine (greater than 1.3 mg/dl) levels.
Final confirmation of the diagnosis may be difficult because many of these test results also occur in other disorders (primary fibrinolysis, for example). Additional diagnostic measures determine the underlying disorder.
Source: Handbook of Diseases, 2003
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