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.
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