Diagnosis of Disseminated Intravascular Coagulation: Role of D-Dimer

SummaryTo determine the role of plasma tissue factor on disseminated intravascular coagulation (DIC) in trauma and septic patients, and also to investigate the relationships between tissue factor and various thrombin markers, we made a prospective cohort study. Forty trauma patients and 20 patients with sepsis were classified into subgroups according to the complication of DIC. Plasma tissue factor antigen concentration (tissue factor), prothrombin fragment F1+2 (PF1+2), thrombin antithrombin complex (TAT), fibrinopeptide A (FPA), and D-dimer were measured on the day of admission (day 0), and on days 1, 2, 3, and 4 after admission. The levels of plasma tissue factor in the DIC group were more elevated than those of the non-DIC group in both the trauma and the septic patients. In patients with sepsis, tissue factor levels on days 0 through 4 in the non-DIC group showed markedly higher values than those in the control patients (135 ± 8 pg/ml). Significant correlations between tissue factor and PF1+2, TAT, FPA, and D-dimer were observed in the DIC patients, however, no such correlations were found in the non-DIC patients. These results suggest that elevated plasma tissue factor in patients with trauma and sepsis gives rise to thrombin generation, followed by intravascular coagulation.

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Antiphospholipid Antibodies in Patients with COVID-19

10.5772/intechopen.95261 ◽

2020 ◽

Author(s):

Cristiana Isabel Sieiro Santos

Keyword(s):

Disseminated Intravascular Coagulation ◽

Inflammatory Mediators ◽

Antiphospholipid Antibodies ◽

Pulmonary Thromboembolism ◽

Coagulation Parameters ◽

Intravascular Coagulation ◽

Peripheral Ischemia ◽

Clinical Associations ◽

D Dimer

Patients infected with COVID-19 are at higher risk of thrombosis, suggesting an important role of COVID-19 induced coagulopathy. Abnormal coagulation parameters such as elevation in D-dimer are found in patients, with frequent thrombotic events ranging from peripheral ischemia, pulmonary thromboembolism to disseminated intravascular coagulation. Recently, the role of antiphospholipid antibodies (aPL) in the pathophysiology of COVID-19 have been questioned but it remains unclear whether they contribute to coagulopathy. We aim to evaluate the presence of aPL, including LAC, aCL (IgG, IgM), aβ2GPI (IgG, IgM) in a cohort of patients with SARS-CoV-2, study clinical associations and discuss the relevance. The relevance of aPLs in patients with COVID-19 is yet to be determined. Inflammation is closely associated to thrombosis and the presence of inflammatory mediators in COVID-19 infection can lead to thrombosis. Further studies are needed before to determine the role of aPL in COVID-19 patients and their relationship with thrombosis. The presence of aPL should be carefully interpreted as it is important to evaluate the persistence of aPL positivity in patients infected with COVID-19.

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Disseminated intravascular coagulation syndrome

Vrač skoroj pomoŝi (Emergency Doctor) ◽

10.33920/med-02-2004-01 ◽

2020 ◽

pp. 22-40

Author(s):

A. Kulikov

Keyword(s):

Clinical Practice ◽

Disseminated Intravascular Coagulation ◽

Blood Cells ◽

Physical State ◽

Clinical Manifestations ◽

Vascular Wall ◽

Stages Of Development ◽

Intravascular Coagulation ◽

Hemostatic Disorder

Presented material reveals main links in the pathogenesis of hemostatic disorder. In particular, attention is paid to the role of the lungs, liver and other organs in the development of this process. Role of vascular wall and blood cells in regulation of the physical state of blood is described in detail. The most frequent factors leading to hypercoagulation are indicated. Difference between hypercoagulation and thrombophilia is shown. The latter is found in clinical practice quite often, but at the same time, it is poorly diagnosed. Such a terrible complication of hemostatic disorder as disseminated intravascular coagulation is described. Its classification, stages of development, clinical manifestations are offered to the readers.

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On the Rôle of Disseminated Intravascular Coagulation in the Pathology of Birth Asphyxia

Developmental Medicine & Child Neurology ◽

10.1111/j.1469-8749.1974.tb04177.x ◽

2008 ◽

Vol 16 (5) ◽

pp. 581-591 ◽

Cited By ~ 10

Author(s):

J. M. Anderson ◽

J. K. Brown ◽

F. Cockburn

Keyword(s):

Disseminated Intravascular Coagulation ◽

Birth Asphyxia ◽

Intravascular Coagulation

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Role of leukocytes in disseminated intravascular coagulation

Pathophysiology ◽

10.1016/0928-4680(94)90438-3 ◽

1994 ◽

Vol 1 ◽

pp. 210

Author(s):

K. Okajima ◽

M. Uchida ◽

K. Murakami ◽

H. Okabe ◽

K. Takatsuki

Keyword(s):

Disseminated Intravascular Coagulation ◽

Intravascular Coagulation

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False-Positive D-Dimer Result in a Patient With Castleman Disease

Archives of Pathology & Laboratory Medicine ◽

10.5858/2004-128-328-fdriap ◽

2004 ◽

Vol 128 (3) ◽

pp. 328-331

Author(s):

Kimberly Mugler ◽

Jerry B. Lefkowitz

Keyword(s):

Western Blot ◽

Disseminated Intravascular Coagulation ◽

False Positive ◽

Degradation Products ◽

False Negative ◽

Castleman Disease ◽

Laboratory Findings ◽

Intravascular Coagulation ◽

Immunodeficiency Virus ◽

D Dimer

Abstract In suspected cases of disseminated intravascular coagulation, concurrent elevation of both fibrin(ogen) degradation products (FDPs) and D-dimer levels aids in confirming the diagnosis. This pattern of results reflects the action of plasmin proteolysis of cross-linked fibrin polymers as well as fibrinogen. We report the case of a patient with human immunodeficiency virus (HIV) and Castleman disease who presented with a high-positive D-dimer level and a negative FDP level in the course of a workup for disseminated intravascular coagulation. This finding suggested the possibility of either a false-positive D-dimer or a false-negative FDP level. To investigate the former, a Western blot was performed on the patient's serum to determine the presence of the D-dimer. No D-dimer band was visualized on the Western blot, confirming the false-positive nature of the D-dimer result. Insufficient quantity of patient serum, however, prevented further investigation into the etiology of this result. The false-positive D-dimer result is likely attributable to interference caused by the patient's Castleman disease–associated monoclonal gammopathy, a phenomenon that has been reported in other immunoassays. As the development of lymphoproliferative disorders is especially common within the HIV population, and hypergammaglobulinemia in Castleman disease is particularly common, clinicians should be aware of this phenomenon when the laboratory findings do not fit the clinical picture. Although it is rare, recognition of potential paraprotein interference in immunoassays will help avoid undertreatment or overtreatment of patients based on erroneous laboratory results.

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Disseminated intravascular coagulation at diagnosis is a strong predictor for thrombosis in acute myeloid leukemia

Blood ◽

10.1182/blood-2016-02-701094 ◽

2016 ◽

Vol 128 (14) ◽

pp. 1854-1861 ◽

Cited By ~ 26

Author(s):

Eduard J. Libourel ◽

Clara P. W. Klerk ◽

Yvette van Norden ◽

Moniek P. M. de Maat ◽

Marieke J. Kruip ◽

...

Keyword(s):

Acute Myeloid Leukemia ◽

Disseminated Intravascular Coagulation ◽

Arterial Thrombosis ◽

Myeloid Leukemia ◽

Strong Predictor ◽

Newly Diagnosed ◽

Intravascular Coagulation ◽

Key Points ◽

D Dimer ◽

Acute Myeloid

Key Points A high D-dimer level strongly predicts symptomatic venous and arterial thrombosis in newly diagnosed AML. Thrombosis occurs in up to 10% of patients with newly diagnosed AML.

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Role of endothelin in disseminated intravascular coagulation

American Journal of Hematology ◽

10.1002/ajh.2830410202 ◽

1992 ◽

Vol 41 (2) ◽

pp. 71-75 ◽

Cited By ~ 16

Author(s):

H. Asakura ◽

H. Jokaji ◽

M. Saito C. Uotani ◽

I. Kumabashiri ◽

E. Morishita ◽

...

Keyword(s):

Disseminated Intravascular Coagulation ◽

Intravascular Coagulation

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D-dimer kit with a High FDP/D-Dimer Ratio is Useful for Diagnosing Thrombotic Diseases

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/10760296211070584 ◽

2022 ◽

Vol 28 ◽

pp. 107602962110705

Author(s):

Nozomi Ikeda ◽

Hideo Wada ◽

Yuhuko Ichikawa ◽

Minoru Ezaki ◽

Motoko Tanaka ◽

...

Keyword(s):

Venous Thromboembolism ◽

Critically Ill ◽

Disseminated Intravascular Coagulation ◽

Critically Ill Patients ◽

Degradation Products ◽

Intravascular Coagulation ◽

Fibrin Degradation Products ◽

Peripheral Arterial ◽

Thrombotic Diseases ◽

D Dimer

Introduction Although D-dimer is a useful biomarker of thrombosis, there are many D-dimer kits, with high and low fibrinogen and fibrin degradation products (FDP)/ D-dimer ratios. Methods Plasma D-dimer levels were measured using three different kits in critically ill patients to examine the usefulness of such measurements for detecting the thrombotic diseases and determining the correlation with the FDP and FDP/D-dimer ratio. Results Although three D-dimer kits showed marked utility for diagnosing disseminated intravascular coagulation (DIC) and peripheral arterial and venous thromboembolism (PAVTE), the D-dimer levels determined using the three kits varied among diseases. Indeed, one D-dimer kit showed a high FDP/D-dimer ratio, and another kit showed a low FDP/D-dimer ratio. D-dimer kit with low FDP/D-dimer ratio tended to have high cut-off values and low specificity for diagnosing DIC and PAVTE. In D-dimer kit with high FDP/D-dimer ratio, FDP/D-dimer ratios in patients with thrombosis was significantly higher than that in patients without thrombosis. Conclusion All three D-dimer kits show utility for detecting thrombotic diseases. However, the D-dimer levels determined using the kits varied due to differences in the FDP/D-dimer ratio. In combination with the FDP level, a D-dimer kit with a high FDP/D-dimer ratio may be useful.

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