What role does the measurement of fibrinogen and its derivatives have in the diagnosis of disseminated intravascular coagulation?

Diagnosis of disseminated intravascular coagulation (DIC) is based on the detection of indicators of in vivo coagulation activation in patients without evidence of localized thrombus formation. DIC is a frequent finding in patients with sepsis and malignancy, as well as other conditions associated with the exposition of procoagulant cellular or non-cellular surfaces to the flowing blood. DIC may lead to microvascular occlusion, as well as to consumption of procoagulant activity. Early diagnosis of DIC is achieved by measurement of fibrin-related parameters such as D-dimer antigen, fibrin monomer antigen, soluble fibrin complexes, or fibrin degradation products. Quantitative assays allow diagnosis and monitoring of DIC. New assays using monoclonal antibodies directed against epitopes specific for elastase-mediated fibrin degradation may add valuable diagnostic information in patients with septic conditions.