Production of other mediators such as interleukin - 1 and tumour necrosis factor may also damage endothelial cells, and platelet activation may also follow activation of the complement cascade by endotoxin. Initiation of the coagulation system leads thromboplastin to form thrombin and results in production of fibrin from fibrinogen. At the same time, activation of Hageman factor converts plasminogem to plasmin, which is fibrinolytic . Fibrin degradation products inhibit thrombin activity, fibrin polymerisation and platelet aggregation. Activation of the kallikrein-kinin system occurs together with activation of the coagulation pathway.
Kinins increase vascular permeability and contribute to circulatory failure, due to hypotension .
Clinically, and at post-mortem examination, there are often widespread haemorrhages . Although DIC implies there is intravascular coagulation, that process depletes the circulation of available clotting factors . . .