In DIC, depletion of which substance leads to consumption of coagulation factors and potential unremitting hemorrhage?

• A. Fibrin
• B. Platelets
• C. Fibrinogen
• D. Factor VIII

Answer: (A)

Disseminated intravascular coagulation (DIC) is a consumptive coagulopathy where widespread activation of the coagulation system leads to formation of fibrin in the microvasculature. This immense fibrin formation uses up clotting factors and platelets. As these factors are consumed, the body loses its ability to form new clots adequately, which can then manifest as unremitting bleeding. The presence and depletion of fibrin specifically signal that the coagulation cascade has been massively activated and are tied to the ensuing consumption of factors and the bleeding risk.

Fibrinogen and platelets are also used up during this process, and factor VIII is among the factors consumed, but the formation and depletion of fibrin reflect the central giving-way of the coagulation system in DIC, making fibrin the most representative marker of that consumptive process leading to hemorrhage.