View source for D-dimer


==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 patients 50 years or older) = age x 10
**D-dimer less than OR equal to age x 10 makes VTE unlikely
**Maintains high sensitivity while increasing specificity<ref>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.</ref>
*YEARS<ref>MDCalc YEARS https://www.mdcalc.com/years-algorithm-pulmonary-embolism-pe</ref> and PEGeD<ref>Anand Swaminathan, "PEGeD Study – Is It Safe to Adjust the D-Dimer Threshold for Clinical Probability?", REBEL EM blog, December 16, 2019. Available at: https://rebelem.com/peged-study-is-it-safe-to-adjust-the-d-dimer-threshold-for-clinical-probability/</ref> adjust cut off base on clinical probability still being studied.

==See Also==
*[[Age adjusted D-dimer]]
*[[Pulmonary embolism]]
*[[Deep venous thrombosis]]
*[[Pulmonary_embolism_in_pregnancy#D-Dimer|D-dimer for pulmonary embolism in pregnancy]]

==External Links==
*[http://www.ncbi.nlm.nih.gov/pubmed/22284935 D-dimer threshold increase. Kline et. al.]
*[http://pemplaybook.org/podcast/big-labs-little-people-troponin-bnp-d-dimer-and-lactate/ Pediatric Emergency Playbook Podcast: Big Labs, Little People]

==References==
<references/>

[[Category:Cardiology]]
[[Category:Pulmonary]]
[[Category:Vascular]]