D-Dimer | Coagulation - MedSchool
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Coagulation
 

D-Dimer

 
 

Overview

  • Fibrin D-dimer is a measurement of cross-linked fibrin degradation products, generally indicative of clot formation with active clot breakdown.
      • Normal Range

      • <250 ng/mL

Elevated D-Dimer

  • Elevated D-dimer is a non-specific finding as it can be caused by the myriad of conditions listed below.
    • Causes of Elevated D-Dimer

    • Non-Pathological

    • Advanced age
    • Pregnancy
    • Cigarette smoking
    • Postoperative state
    • Pathological

    • Trauma
    • Infection
    • Inflammation
    • Malignancy
    • Preeclampsia / eclampsia
    • Disseminated intravascular coagulation (DIC)
    • Intracardiac thrombus
    • Arterial atheroembolism
    • Venous thromboembolism (e.g. DVT, PE)
    • Superficial thrombophlebitis
    • Myocardial infarction
    • Ischaemic stroke
    • Aortic dissection
    • Thrombolytic therapy
    • Chronic kidney disease
    • Congestive cardiac failure
    • Severe liver disease
    • Sickle cell crisis
    • Acute GI haemorrhage

    Elevated D-Dimer and PE

      • Practical Points

      • The D-dimer is sometimes tested as part of the diagnostic workup for pulmonary embolism.
      • The test has a high negative predictive value for PE, meaning that a negative result is useful for ruling out PE in patients who have a low pre-test probability.
      • A positive value should be interpreted with caution and taken in the context of the patient’s other clinical features.
    Last updated on January 19th, 2018
     
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