Pakistan Journal of Medical Sciences

Published by : PROFESSIONAL MEDICAL PUBLICATIONS

ISSN 1681-715X

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CASE REPORT

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Volume 24

April - June 2008 (Part-I)

Number  2


 

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Dealing with markedly elevated false positive
d-dimer by sequential testing with two d-dimer assays

Khawaja Afzal Ammar1, Molly Shapiro2

ABSTRACT

False positive D-dimers are common & lead to an expensive confirmatory work-up. The approach of a highly sensitive assay for screening followed by a highly specific assay for confirmation, commonly used in diagnosing AIDS and Lyme disease, have not been applied to D-dimer testing. We describe a case of a 32-year old female with pleuritic chest pain and a D-dimer of >2000g/l. Although negative chest CT and leg ultrasound for thromboembolism were performed, persistent pleuritic chest pain mandated further work-up. We used a confirmatory D-dimer assay with much higher specificity to declare the first test false positive. Such a negative confirmatory test can save further follow-up, work-up, and anxiety on both the parts of patient and physician, and should be considered in diagnostic algorithms of venous thromboembolism.

KEY WORDS: False positive D-dimer, Venous thromboembolism.

Abbreviations and Acronyms: AIDS = Acquired Immune Deficiency Syndrome,

CT = Computerized Tomography, DVT = Deep Venous Thrombosis,ECG = Electrocardiogram,

ELISA = Enzyme Linked ImmunoSorbent Assay, GI = GastroIntestinal, LA = Latex Agglutination ,

PE = Pulmonary Embolism, US = Ultrasound

Pak J Med Sci    April - June 2008 (Part-I)    Vol. 24 No. 2    321-323


1. Khawaja Afzal Ammar, MD
2. Molly Shapiro, RN, MSN-MBA, PhD
Division of Cardiology,
Department of Internal Medicine,
Mayo Clinic Rochester, MN
Department of Internal Medicine,
Olmsted Medical Center, Rochester, MN, USA.

Correspondence

Khawaja Afzal Ammar, MD,
Assistant Professor of Medicine,
C/o Tammy Burns, Gonda 5-468,
Division of Cardiovascular Diseases, Mayo Clinic,
200 First Street SW, Rochester, MN 55905.
Email: ammar.khawaja@mayo.edu

* Received for Publication: November 13, 2007
* Accepted: March 6, 2008



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