Higher prognostic value of soluble fibrin complexes than D-dimer and fibrin degradation product for disseminated intravascular coagulation in patients with liver cirrhosis

AbstractThe polyetiological syndrome of disseminated intravascular coagulation (DIC) is characterized by changes in patients’ hemostasis. The aim of the current research was to elucidate the main factors for the development of DIC syndrome during canine babesiosis, and to assess their correlation level. Dogs included in this study were of various breeds and sex, weighing 10-40 kg and aged 2-7 years. They were separated in two groups (n=50) according to their diagnosis to babesiosis. Oscillometry (blood pressure, pulse rate), vascular-platelet hemostasis, coagulogram, hematological, biochemical (fibrinogen, fibrin degradation product, soluble fibrin-monomer complex) and hemodynamic (circulating blood volume) assessment methods were used. The group of dogs positive on Babesia spp., had clear manifestation of DIC with 5-7% of the erythrocyte population being affected. DIC was manifested by a significant increase in soluble fibrin-monomer complex and fibrin degradation product (p<0.001), hypofibrinogenemia (p<0.001), thrombocytopenia (p<0.001), and an increase in indicators of spontaneous aggregation ability of platelets and red blood cells (p<0.001). Significant hemodynamic disorders were observed: a decrease in circulating blood volume, circulating erythrocytes volume (p<0.05), specific circulating blood volume and hematocrit value (p<0.001). The average blood pressure was reduced (p<0.001), and the Allgöwer’s shock index was increased 2 times (p<0.05). A shock of II degree (medium, subcompensated) was confirmed. Therefore, it can be concluded that acute spontaneous dogs’ babesiosis can be characterized by the occurrence of DIC in a consumption coagulopathy form, and shock of II degree. This condition renders the patients for emergency admission.

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ISTH overt disseminated intravascular coagulation score in patients with septic shock: automated immunoturbidimetric soluble fibrin assay vs. D-dimer assay

Journal of Thrombosis and Haemostasis ◽

10.1111/j.1538-7836.2011.04270.x ◽

2011 ◽

Vol 9 (6) ◽

pp. 1252-1255 ◽

Cited By ~ 8

Author(s):

J.-C. GRIS ◽

J.-L. FAILLIE ◽

É. COCHERY-NOUVELLON ◽

G. LISSALDE-LAVIGNE ◽

J.-Y. LEFRANT

Keyword(s):

Septic Shock ◽

Disseminated Intravascular Coagulation ◽

Soluble Fibrin ◽

Intravascular Coagulation ◽

D Dimer

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Measurement of soluble fibrin monomer-fibrinogen complex in plasmas derived from patients with various underlying clinical situations

Thrombosis and Haemostasis ◽

10.1055/s-0037-1613469 ◽

2003 ◽

Vol 89 (05) ◽

pp. 832-836 ◽

Cited By ~ 15

Author(s):

Yumiko Kazahaya ◽

Yuichi Shintani ◽

Kensuke Yamazumi ◽

Yutaka Eguchi ◽

Shin Koga ◽

...

Keyword(s):

Molecular Markers ◽

Disseminated Intravascular Coagulation ◽

Degradation Products ◽

Research Society ◽

Distinct Entity ◽

Soluble Fibrin ◽

Intravascular Coagulation ◽

Fibrin Degradation Products ◽

Fibrin Monomer ◽

D Dimer

SummaryWe previously reported a monoclonal antibody named IF-43 that specifically recognizes thrombin-modified fibrinogen (desAA- and desAABB- fibrin monomer) bound with fibrinogen or other D1 domain-containing plasmic fragments such as fragments X, Y, and D1, but not intact fibrinogen or cross-linked fibrin degradation products (XDP). Here, we tentatively named such complexes, soluble fibrin monomer (FM) -fibrinogen complex.By utilizing IF-43, we have developed a kit to measure soluble FM-fibrinogen complex and compared the profiles with those of two established molecular markers for thrombo-embolic disorders: i.e. the thrombin-antithrombin complex (TAT) and the D-dimer in plasma of patients who underwent surgery without any thrombo-embolic complications. The result indicated that soluble FM-fibrinogen complex is a distinct entity from the two established molecular markers. We have also attempted to observe their profiles in patients with the disseminated intravascular coagulation syndrome (DIC). Although the profiles of soluble FM-fibrinogen complex in individual patients appeared to vary from one patient to the other, the plasma level of soluble FM-fibrinogen complex was found to be increased at the initial phase of disseminated intravascular coagulation syndrome. Thus, the soluble FM-fibrinogen complex may serve as an independent molecular marker for the detection of thrombin generation and the diagnosis of thrombosis. The soluble FM-fibrinogen complex may also serve as a risk factor for thrombosis, because it may precipitate as insoluble complexes beyond its threshold in plasma, or when it is modified by thrombin.Part of this paper was originally presented at the 17th International Fibrinogen Workshop of the International Fibrinogen Research Society (IFRS) held in Munich, Germany, September, 2002.

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Soluble Fibrin and Fibrinogen-Derived Material in the Kidneys during Low-Graded Disseminated Intravascular Coagulation (DIC) in Rabbits

Scandinavian Journal of Haematology ◽

10.1111/j.1600-0609.1974.tb00250.x ◽

2009 ◽

Vol 13 (2) ◽

pp. 152-159 ◽

Cited By ~ 5

Author(s):

R. A. Slaastad ◽

G. Husby ◽

F. Skjörten

Keyword(s):

Disseminated Intravascular Coagulation ◽

Soluble Fibrin ◽

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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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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