Disseminated intravascular coagulation is most often triggered by which category of conditions?

• A. Hypothyroidism
• B. Infections (bacterial, viral, fungal)
• C. Chronic kidney disease
• D. Osteoarthritis

Answer: (B)

Disseminated intravascular coagulation is a consumptive coagulopathy where widespread activation of the coagulation system creates microthrombi and uses up platelets and clotting factors, leading to bleeding and organ dysfunction. The most common trigger is infection, especially sepsis, because bacteria and their products trigger a strong inflammatory response that activates tissue factor and the coagulation cascade throughout the vasculature. This systemic activation causes numerous small clots, consumes platelets and coagulation factors, and then promotes secondary fibrinolysis. Lab patterns typically show low platelets, prolonged PT and aPTT, low fibrinogen, and elevated D-dimer. Other conditions listed—hypothyroidism, chronic kidney disease, and osteoarthritis—don’t usually initiate this widespread consumptive process.