D-dimer
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Differential Diagnosis
- Factors that can cause false-negative D-dimer
- Symptoms of PE > 3 days
- Small PE
- Use of qualitative latex fixation test
- Use of anticoagulants
- Factors that can cause false-positive D-dimer
- Cancer and malignancy
- Recent surgery
- Infection (eg, pneumonia, sepsis)
- Pregnancy
- Age > 70 years
- DIC
- Trauma
- Arterial thrombosis
- ACS/AMI
- Vaso-occlusive sickle cell crisis
- Acute CVA
- Vasculitis
- Superficial phlebitis
Evaluation
- Traditional cutoff value = 500
- Age-adjusted (for over 50 years old) = age x 10
- Maintains high sensitivity while increasing specificity[1]
See Also
- Age adjusted D-dimer
- Pulmonary embolism
- Deep venous thrombosis
- D-dimer for pulmonary embolism in pregnancy
External Links
- D-dimer threshold increase. Kline et. al.
- Pediatric Emergency Playbook Podcast: Big Labs, Little People
References
- ↑ Sharp AL, et al. An Age-Adjusted D-dimer Threshold for Emergency Department Patients with Suspected Pulmonary Embolus: Accuracy and Clinical Implications. Feb 2016. Annals of EM. 67(2);249-257.