25 May 2022

Episode 016: Heme/Onc Emergencies, Pt. 5: DIC and Intro to TMAs

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The Fellow on Call: The Heme/Onc Podcast

The podcast episode delves into the diagnosis and management of Disseminated Intravascular Coagulation (DIC), a critical hematologic emergency. The discussion centers around a case of a patient presenting with fever, diarrhea, and abnormal vitals, complicated by thrombocytopenia and AKI, leading to a differential diagnosis including DIC, TTP, and HUS. Key considerations include interpreting coagulation studies, especially fibrinogen levels, and the role of blood smear analysis in identifying schistocytes. The speakers emphasize the importance of replacing consumed coagulation factors and platelets, while cautioning against over-reliance on INR for assessing coagulation status in DIC. They also explore the complexities of distinguishing DIC from liver disease-related coagulopathies, highlighting the utility of specific factor activity levels in diagnosis.

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