Schematic presentation of pathogenetic pathways involved in the activation of coagulation in DIC. In DIC, both perturbed endothelial cells and activated mononuclear cells may produce proinflammatory cytokines that mediate coagulation activation. Activation of coagulation is initiated by tissue factor expression on activated mononuclear cells and endothelial cells. In addition, downregulation of physiologic anticoagulant mechanisms and inhibition of fibrinolysis by endothelial cells further promote intravascular fibrin deposition. PAI-1, plasminogen-activator inhibitor type 1.
Source: Williams Hematology, 8th ed, Chap. 130, Fig. 130–1, p. 2102.