Table 181 O Conditions That May Elevate Fibrin Degradation Products

• Disseminated intravascular coagulation

• Pulmonary embolism

• Abruptio placentae

• Preeclampsia

• Fetal death in utero

• Postpartum hemorrhage

• Polycystic disease

• Malignancies

• Lupus nephritis

• Thrombolytic therapy and indirectly are an indication that clots have been formed at the site of injury, at the local level. Excess d-dimers are indicative of breakdown of fibrin products within the circulating blood. D-dimers can be assayed semiquantitatively and quantitatively. The semiquantitative assay uses monoclonal antibodies specific for this domain. A simple agglutination test, undiluted patient plasma is mixed with latex solution. Noticeable agglutination is a positive test and indicative of deep vein thrombosis (DVT), pulmonary embolism (PE), or disseminated intravascular coagulation (DIC). Quantitative D-dimer tests are automated and use an enzyme-linked immunosorbent assay (ELISA) procedure. The advantage of this procedure is its ability to detect low levels of D-dimer and to provide specific information as to whether pathological clotting as in DVT or PE has occurred. D-dimers assays have great utility in monitoring thrombolytic therapy.8

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