Paediatria Croatica, Vol. 60 No. 4, 2016.
Review article
https://doi.org/10.13112/PC.2016.24
How to interpret D-dimer fi nding correctly
Renata Zrinski Topić
orcid.org/0000-0002-3740-7854
; Klinika za dječje bolesti Zagreb, Zavod za laboratorijsku dijagnostiku, Odjel za medicinsku biokemiju i hematologiju, Klaićeva 16, 10000 Zagreb
Jasna Leniček Krleža
orcid.org/0000-0002-2554-4034
Abstract
The aim is to point to the preanalytical, analytical and postanalytical characteristics and limitations of D-dimer determination while
tending to the rational use of laboratory test and correct interpretation of the fi ndings and literature citations. Low level of D-dimer
can be found in good health condition, whereas pathologically elevated D-dimer level is recorded in clinical conditions associated
with increased coagulation and fi brinolytic activities or altered D-dimer metabolism. Routine determination of D-dimer is used for
diagnosing and treatment monitoring of disseminated intravascular coagulation, and in diff erential diagnosis of thromboembolic
conditions. Due to the high negative predictive value, D-dimer concentration lower than the cutoff value excludes the diagnosis of
thromboembolic diseases and helps in screening patients that need additional work-up using expensive imaging methods. Immunoassays
for quantitative determination of D-dimer concentration are not standardized. Monoclonal anti-D-dimer antibodies of
diff erent specifi cities and diff erent detection reactions have been used, resulting in heterogeneity of fi ndings and precluding
comparison of diff erent assays. Therefore, for accurate, reliable report and interpretation of results it is necessary to fulfi ll preanalytical
requirements such as time of blood sampling, correct performance of the method for determination of D-dimer concentration,
and awareness of the limitations of D-dimer determination in particular pathologic conditions.
Keywords
D-dimer; disseminated intravascular coagulation; fi brinolysis; fi brin fi brinogen degradation products; venous thrombosis
Hrčak ID:
180890
URI
Publication date:
23.12.2016.
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