D-dimer

• D-dimers are detectable in acutely formed fibrin complexes as well as in proteolytic degradation products of fibrin clots. The formation of fibrin is not specific for venous thrombosis and embolism. Elevated D-dimer levels can also be detected in nonthrombotic diseases and conditions such as surgery, hemorrhage, trauma, tumor disease, inflammatory reactions, and pregnancy.
• Elevated D-dimer levels are found particularly in deep vein thrombosis, pulmonary embolism, consumptive coagulopathy, neoplasia (including leukemia, neoplasia of the lung and ovaries), sickle cell disease, therapy monitoring of thrombotic patients, follow-up of coagulation activation, disseminated intravascular coagulation (DIC), sepsis, post-transplant rejection crisis, and physical and emotional stress.

Caution. High sensitivity (80-95%) of D-dimer determination. Normal D-dimer concentrations exclude venous thrombosis, pulmonary embolism and disseminated intravascular coagulation with high probability!

1. Kelly J, Hunt BJ (2002) Role of D-dimers in diagnosis of venous thromboembolism. Lancet 359: 456-458
2. Lensing AW et al (1999) Deep-vein thrombosis. Lancet 353:479-485
3. Pedro J, Nunes L (2002) D-dimers in diagnosis of pulmonary embolism. Lancet 360: 489
4. Perrier A et al (1999) Non-invasive diagnosis of venous thromboembolism in outpatients. Lancet 353: 190-195