Hence, the thrombin generation is contained at the site of tissue damage. DIC occurs when this antagonist systems of coagulation and anticoagulation are not balanced. Any component of the fire may be present in excess or the extinguishers may be damaged or rapidly used up, allowing the thrombin explosion to spread uncontrolled throughout the circulation. The endothelium may be disrupted so that tissue factor is released from tissue damaged by trauma, ischemia, infections, excessive metabolic stress, heat, chemicals, tumors or activation of the complement cascade. Alternatively, white blood cells may release tissue factor into the circulation in response to endotoxins, immune complexes or cancer cells.
Snake venoms are capable of activating many components of the hemostatic system.
Also, cytokine action may be critical to the development of DIC in many diseases. For example, TNF and Interleukin 1 can elicit production of tissue factor by endothelial cells and monocytes while simultaneously reducing the expression of thrombomodulin. Thus, when there is an inflammatory reaction, the hemostatic balance is shifted towards coagulation and away from anticoagulation. Acute DIC is usually associated with infections, the commonest cause. Systemic fungal infections, malaria, hemorrhagic fevers, herpes and influenza viruses are other recognized causes.