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Content text Bleeding disorder-3 (DIC)- Final.pdf

CASE: Clinical History: A 25 year old female with 8 months amenorrhea complained of decreased foetal movements. Ultrasonography showed intrauterine foetal death. Several hours later she started experiencing dyspnoea , chest pain and abdominal pain. On examination: Temp- 40 degree Celsius, BP- 80/50mmHg, RR- 26/min, HR- 160/min, Oxygen saturation-88%. She began to bleed from IV line and had 2 episodes of hemoptysis. Her skin showed petechiae and ecchymosis. Laboratory investigation: Parameters Normal range 1. WBC-16000/uL 4000 – 11000/uL 2. Hb-8.0 g/dl 12.0 -15.0 g/dl 3. Platelet-30000/uL 1.5 lakh-4 lakh/uL 4. BT- 11mins 2-6 mins 5. CT-20mins 8- 15mins 6. PT-30 seconds 10 -14 seconds; PI 2.0 (Normal- 1.0) 7. aPTT- 55 seconds 30 – 40 seconds 8. D-dimer-2.0 less then 0.5ug/ml 9. FDP-30 less than or equal to 10mg/l Peripheral smear- RBC’s: normochromic , anisocytosis+, schistocytes+ Differential Count: Polymorphs-88%, lymphocytes-10%, monocyte-1%, eosinophils-1% Toxic Granules ++

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