D-Dimer, Quantitative

The D-Dimer, Quantitative test contains 1 test with 1 biomarker.

Brief Description: The D-Dimer Quantitative test measures the levels of D-dimer in the blood. D-dimer is a fibrin degradation product that is formed when a blood clot (thrombus) dissolves in the body. This test helps in assessing the presence of abnormal blood clotting and is commonly used to diagnose or rule out conditions involving thrombosis.

Also Known As: Fragment D-Dimer Test, Fibrin Degradation Fragment Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

When is a D-Dimer test ordered?

When a patient presents to the emergency room with signs of a dangerous disease, D-dimer testing is frequently prescribed.

When a patient exhibits signs of pulmonary embolism or deep vein thrombosis, a D-dimer test may be prescribed.

When a doctor suspects that another condition other than deep vein thrombosis or pulmonary embolism is the likely cause of symptoms, D-dimer is particularly helpful. It is a rapid, non-invasive method that can help rule out excessive or irregular coagulation. However, it should not be taken if a clinical examination indicates that there is a high likelihood of pulmonary embolism.

To help in the diagnosis of disseminated intravascular coagulation, a D-dimer test coupled with a PT, PTT, fibrinogen, and platelet count may be prescribed for someone who exhibits symptoms like bleeding gums, nausea, vomiting, intense muscle and abdominal pain, seizures, and decreased urine output. When someone is receiving therapy for DIC, D-dimer orders may also be placed periodically to help track the condition's development.

What does a D-Dimer blood test check for?

One of the protein fragments created when a blood clot dissolves in the body is called D-dimer. Normally, it goes unnoticed until the body is generating and dissolving blood clots. Its blood level may then increase as a result. D-dimer in the blood is found using this test.

The body starts a process known as hemostasis when a blood vessel or tissue is injured and starts bleeding in order to form a blood clot that will eventually stop the bleeding. A fibrin net is created by the crosslinking of fibrin threads, which are produced as a result of this process. Platelets and that net work together to contain the blood clot that is forming until the wound has healed.

The body utilizes an enzyme called plasmin to break the thrombus into small pieces so that it can be eliminated after the area has had time to heal and the clot is no longer required. Known as fibrin degradation products, the fragments of the breaking down fibrin in the clot are made up of different sized bits of crosslinked fibrin. D-dimer, one of the last byproducts of fibrin breakdown, can be detected in blood samples and quantified. When blood clots are formed and broken down significantly in the body, the level of D-dimer in the blood may increase.

The D-dimer test's strength is that it can be utilized in a hospital emergency room setting to assess the likelihood of a clot's existence for a person who is at low or moderate risk for blood clotting and/or thrombotic embolism. If the D-dimer test is negative, a thrombus is extremely unlikely to be present. A positive D-dimer test, however, cannot indicate the presence or absence of a clot. It suggests that additional testing is necessary.

Unwanted blood clot formation is related to a number of variables and diseases. Deep vein thrombosis, which causes clots to form in the body's deep veins, most usually in the legs, is one of the most frequent. These clots have the potential to become very large and obstruct blood flow to the legs, resulting in swelling, discomfort, and tissue damage. It is possible for a fragment of the clot to separate and spread to different bodily regions. This "embolus" may become lodged in the lungs and result in pulmonary embolism. Up to 300,000 deaths in the U.S. are attributed to pulmonary embolisms brought on by DVT each year.

Clots can develop in different places, though they most frequently do so in the veins of the legs. Any of these places may benefit from D-dimer measurements to aid in the discovery of clots. For instance, myocardial infarction is brought on by clots in the coronary arteries. When the heart is pounding irregularly or when the valves are damaged, clots are more likely to form on the lining of the heart or its valves. Additionally, clots can develop in big arteries due to atherosclerosis-related constriction and damage. Such clot fragments may break off and create an embolus, which stops an artery in another organ, such the kidneys or the brain.

In addition to other tests, D-dimer measurements may be requested to assist in the diagnosis of disseminated intravascular coagulation. DIC is a condition when the body's clotting factors are activated and subsequently depleted. This causes multiple small blood clots to form while also making the victim susceptible to heavy bleeding. It is a challenging, occasionally fatal illness that can develop following a number of medical procedures, infections, toxic snake bites, liver diseases, and postpartum conditions. While the underlying ailment gets better, measures are taken to support the affected person. In DIC, the D-dimer level is frequently very high.

Lab tests often ordered with a D-Dimer test:

When a Quantitative D-Dimer test is ordered, it's often part of a broader evaluation for clotting disorders and related conditions. Here are some tests commonly ordered alongside it:

1. Complete Blood Count (CBC):

   • Purpose: To evaluate overall blood health, including red and white blood cells, and platelets.
   • Why Is It Ordered: To assess for signs of anemia, infection, or other hematological abnormalities that can accompany or contribute to thrombotic conditions.

2. Prothrombin Time (PT) and International Normalized Ratio (INR):

   • Purpose: To assess the extrinsic pathway of coagulation and monitor anticoagulant therapy.
   • Why Is It Ordered: To evaluate the blood's clotting tendency, especially in patients on anticoagulant therapy.

3. Activated Partial Thromboplastin Time (aPTT):

   • Purpose: To measure the function of the intrinsic pathway of the coagulation cascade.
   • Why Is It Ordered: To assess the blood's clotting tendency and monitor heparin therapy.

4. Fibrinogen:

   • Purpose: To measure the level of fibrinogen, a key protein involved in blood clot formation.
   • Why Is It Ordered: To evaluate the body's ability to form clots, as fibrinogen is converted to fibrin during clot formation.

5. Lupus Anticoagulant and Antiphospholipid Antibodies:

   • Purpose: To detect antibodies associated with antiphospholipid syndrome, which can cause abnormal clotting.
   • Why Is It Ordered: To identify underlying autoimmune conditions that can lead to increased risk of thrombosis.

6. Liver Function Test:

   • Purpose: To assess liver health.
   • Why Is It Ordered: Liver diseases can affect clotting factor production and overall clotting capability.

7. Kidney Function Test:

   • Purpose: To evaluate kidney function.
   • Why Is It Ordered: Kidney disease can impact overall health and the metabolism of medications used to treat or prevent thrombosis.

These tests, when ordered alongside a Quantitative D-Dimer test, provide a comprehensive view of the patient's clotting status and help in the diagnosis and management of thrombotic disorders. They are crucial for ruling out or confirming the presence of a blood clot and identifying underlying conditions that may predispose to clotting. The specific combination of tests will depend on the individual’s symptoms, medical history, and risk factors for thrombosis

Conditions where a D-Dimer test is recommended:

• Deep Vein Thrombosis (DVT): DVT is a condition where blood clots form in the deep veins of the legs, leading to pain and swelling. Elevated D-dimer levels can suggest the presence of DVT.
• Pulmonary Embolism (PE): PE occurs when a blood clot travels to the lungs. Elevated D-dimer levels may indicate the risk of PE.
• Disseminated Intravascular Coagulation (DIC): DIC is a serious condition where blood clotting and bleeding occur simultaneously. Elevated D-dimer levels can signal DIC.
• Monitoring Thrombosis Treatment: D-Dimer Quantitative tests are used to assess the effectiveness of anticoagulant therapy in preventing and treating blood clots.

How does my health care provider use a D-Dimer test?

D-dimer tests are used to assist in excluding the possibility of an unexpected blood clot.

This test can assist establish whether more testing is required to evaluate diseases and conditions that lead to hypercoagulability, or a propensity to clot unnecessarily.

A D-dimer level can be used to monitor DIC therapy effectiveness and aid in the diagnosis of disseminated intravascular coagulation.

What do my D-Dimer test results mean?

The likelihood that a person examined does not have an acute ailment or disease that causes aberrant clot formation and breakdown increases if the D-dimer result is normal or negative. The majority of medical professionals concur that a negative D-dimer test is most reliable and helpful when it is performed on individuals who are thought to have a low to moderate risk of thrombosis. The test is employed to assist in excluding coagulation as the root of the symptoms.

A high level of fibrin breakdown products may be present if the D-dimer test is positive. It does not specify the location or origin, but rather suggests that there may be major blood clot development and disintegration in the body. For instance, it might be caused by disseminated intravascular coagulation or venous thromboembolism. In DIC, the D-dimer level is frequently very high.

However, because a number of different causes might result in a raised level, an elevated D-dimer does not always mean that a clot is present. Elevated amounts may be present in diseases or conditions where fibrin is not regularly eliminated, such as liver illness, or diseases or conditions where fibrin is not normally cleared, such as recent surgery, trauma, infection, heart attack, and several malignancies. D-dimer is therefore rarely used to exclude VTE in hospitalized patients.

During pregnancy, fibrin is also produced and degraded, which could cause a rise in D-dimer levels. The D-dimer test, combined with a PT, PTT, fibrinogen, and platelet count, may be utilized, however, to help detect DIC in a woman who is pregnant or who is soon after giving birth. Her D-dimer level will be exceedingly high if the woman has DIC.

D-dimer is advised as an additional test. The D-dimer test should only be performed to rule out deep vein thrombosis and not to confirm a diagnosis because it is a sensitive test but has low specificity. When the clinical likelihood of pulmonary embolism is high, it shouldn't be utilized to treat the condition. Follow-up and additional testing may be necessary for both elevated and normal D-dimer levels. Further investigation using diagnostic imaging is necessary for patients with positive D-dimer tests and those who have a moderate to high risk for DVT.

When used to track the effectiveness of DIC treatment, decreasing levels signify success while rising levels could mean treatment failure.

Most Common Questions About the D-Dimer test:

Clinical Utility and Interpretation of the D-Dimer Quantitative Test

What is the D-Dimer Quantitative test, and what is its clinical significance?

The D-Dimer Quantitative test measures the levels of D-Dimer, a protein fragment found in the blood after a blood clot dissolves. It is significant in diagnosing conditions involving thrombosis, such as deep vein thrombosis (DVT), pulmonary embolism (PE), and disseminated intravascular coagulation (DIC).

What conditions might lead to a healthcare provider ordering the D-Dimer Quantitative test?

Healthcare providers may order the D-Dimer Quantitative test when symptoms suggest thrombotic conditions like DVT, PE, or DIC. It can also be used to monitor anticoagulant therapy and to rule out clotting disorders.

How are the results of the D-Dimer Quantitative test interpreted?

Increased levels of D-Dimer may indicate the presence of an underlying clotting disorder, while normal levels may rule out acute thrombotic diseases. The interpretation should be in conjunction with clinical symptoms, medical history, and other laboratory findings.

D-Dimer Quantitative Test in Thrombotic Disorders

How is the D-Dimer Quantitative test used in diagnosing deep vein thrombosis (DVT)?

The D-Dimer Quantitative test is often used as an initial screening tool for DVT. A negative result can exclude DVT in low-risk patients, while a positive result typically leads to further imaging studies for confirmation.

How can the D-Dimer Quantitative test aid in diagnosing pulmonary embolism (PE)?

Similar to DVT, a negative D-Dimer Quantitative test in a low-risk patient can help rule out PE. A positive result necessitates further diagnostic procedures, such as a CT scan or ventilation-perfusion scan.

How is the D-Dimer Quantitative test utilized in the diagnosis and management of disseminated intravascular coagulation (DIC)?

In DIC, the D-Dimer Quantitative test can reveal elevated levels due to excessive clot formation and breakdown. Monitoring D-Dimer levels helps in assessing the severity and progression of DIC and may guide treatment strategies.

Challenges and Limitations in D-Dimer Quantitative Testing

What challenges may arise in interpreting the D-Dimer Quantitative test results?

Interpreting the D-Dimer Quantitative test can be challenging due to false positives in conditions like inflammation, cancer, trauma, and pregnancy. It's essential to interpret the results in the context of the patient's overall clinical situation.

What are the limitations of the D-Dimer Quantitative test in diagnosing thrombotic disorders?

The D-Dimer Quantitative test's sensitivity may lead to false positives, especially in elderly patients or those with underlying conditions that cause elevated D-Dimer levels. It cannot definitively diagnose thrombotic disorders but serves as a screening tool.

D-Dimer Quantitative Test in Treatment Monitoring

How is the D-Dimer Quantitative test used in monitoring anticoagulant therapy?

The D-Dimer Quantitative test can be used to assess the effectiveness of anticoagulant therapy in patients with thrombotic disorders. Decreasing levels may indicate successful treatment, while persistently elevated levels may signal ongoing clotting activity.

Can the D-Dimer Quantitative test guide the duration of anticoagulant therapy?

Yes, the D-Dimer Quantitative test can influence the duration of anticoagulant therapy, particularly in unprovoked venous thromboembolism. Normalizing D-Dimer levels may allow for discontinuation of therapy in some patients.

Interactions with Other Diagnostic Tools

How does the D-Dimer Quantitative test complement other tests in evaluating thrombotic disorders?

The D-Dimer Quantitative test is often used alongside clinical assessment tools and imaging studies. It helps guide the need for further diagnostic procedures and can contribute to a comprehensive evaluation of thrombotic disorders.

Can the D-Dimer Quantitative test be used with imaging studies in diagnosing venous thromboembolism?

Yes, the D-Dimer Quantitative test is often used in conjunction with imaging studies such as ultrasound for DVT and CT scans for PE. A positive D-Dimer Quantitative test may lead to these imaging studies to confirm the diagnosis.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.