Which smear finding is most consistent with disseminated intravascular coagulation (DIC)?

Which smear finding is most consistent with disseminated intravascular coagulation (DIC)?

• A. Spherocytes
• B. Agglutination
• C. Nucleated red blood cells
• D. Schistocytes

Answer: (D)

Disseminated intravascular coagulation causes widespread formation of microthrombi in small vessels, which mechanically fragment red blood cells as they pass through these vessels. This hemolysis produces fragmented red cells called schistocytes on a peripheral smear. Schistocytes are the hallmark of microangiopathic hemolytic processes like DIC. Other options don’t reflect this fragmentation pattern: spherocytes come from membrane loss in immune or hereditary conditions, agglutination is antibody-mediated clumping, and nucleated red cells indicate an aggressive bone marrow response rather than intravascular fragmentation.

Disseminated intravascular coagulation causes widespread formation of microthrombi in small vessels, which mechanically fragment red blood cells as they pass through these vessels. This hemolysis produces fragmented red cells called schistocytes on a peripheral smear. Schistocytes are the hallmark of microangiopathic hemolytic processes like DIC. Other options don’t reflect this fragmentation pattern: spherocytes come from membrane loss in immune or hereditary conditions, agglutination is antibody-mediated clumping, and nucleated red cells indicate an aggressive bone marrow response rather than intravascular fragmentation.