Fragmented Red Cells in Disseminated Intravascular Coagulation

To the Editor: In their letter concerning the diagnostic specificity of erythrocyte fragmentation in disseminated intravascular coagulation, Visudhiphan et al. conclude that clinicians cannot make a diagnosis of this disorder solely on the basis of an examination of a peripheral-blood smear for fragmented red cells (July 14 issue).¹ The criteria for diagnosing disseminated intravascular coagulation in their patient population were a clinical picture of sepsis with a platelet count below 70,000 per cubic millimeter and prolonged partial thromboplastin and prothrombin times. These criteria are much too nonspecific for this disease and could have spuriously diminished the true mean numbers of&.