Title: Diagnostic Efficacy of D-Dimer Test in Patients Suffering from Disseminated Intravascular Coagulation (DIC) Attending in Tertiary Care Hospital at Patna
Authors: Dr Kamla Kumari, Dr O. P. Dwivedi
DOI: https://dx.doi.org/10.18535/jmscr/v7i9.78
Abstract
Objective: D- dimer test is used as a diagnosis test for acute disseminated intravascular coagulation (DIC).This study was undertaken to evaluate the sensitivity and specificity of D- dimer test in the diagnosis of acute DIC and its role in diagnosis of sub- clinical DIC.
Material and Method: A total of 18 patients of clinically diagnosed as acute DIC and 13 patients with sub- clinical DIC were included in the study.
Result: All the patients had positive D- dimer test, and markedly prolonged PT, aPTT and TT were seen in 14 (77.78%) patients. D- dimer test was found to be highly specific but less sensitive for the diagnosis of acute DIC. Out of 13 patients predisposed to sub - clinical DIC D-dimer was positive is 02 (15.38%) patients and PT, aPTT and TT were mildly prolonged in 02(15.38%) patients.
Conclusion: It is suggested that D-dimer positivity for the diagnoses of sub- clinical DIC need to be considered with caution and to be supplemented by other coagulation test including serial follow up with d- dimer and coagulation tests.
Keywords: D-dimer, sub -clinical DIC, acute DIC.
References
- Carr JM, McKinney M, McDonagh J. Diagnosis of disseminated intravascular coagulation. Role of D - dimer. Am J Clin Pathol 1989; 91:280.
- Bovill EG. Disseminated intravasuclar coagulation: pathophysiology and laboratory diagnosis. Fibrinol 1993; 7 (suppl 2):17.
- Bernardi E, Prandoni P, Lensing AW et al. D - dimer testing as an adjunct to ultrasonography in patients with clinically suspected deep vein thrombosis: prospective cohort study. BMJ 1998; 317:1037.
- Deykin D. The clinical challenge of disseminated intravasuclar coagulation. N Engl J Med 1970; 283:636-44.
- Ottp P, Astrup L, Jensen RH et al. Assessment of D - dimer in plasma: diagnostic value in suspected deep vein thrombosis of the leg. Acta Med Scand 1988; 224:263-7.
- Beutler E, Lichtman MA, Coller BS et al. Williams Haematology. 6th ed., 2001.
- Colman RW, Robboy SJ, Minna JD. Disseminated intravasuclar coagulation: a reappraisal. Annu Rev Med 1979; 30:359-74.
- Muller - Berghaus G. Pathophysiologic and biochemical events in disseminated intravascular coagulation: dysregulation of procoagulant and anticoagulant pathways. Semin Thromb Hemost 1989; 15:58-87.
- Baglin T. Disseminated intravascular coagulation: diagnosis and treatment. BMJ 1996; 312:683-7.
- Carr J, McKinney M, McDonagh J. Diagnosis of disseminated intravascular coagulation. Role of D-dimer. Am 1 Clin Pathol 1989; 91:280-7.
- Prisco D, Paniccia R, Bonechi F et al. Evaluation of new method for the selective measurement of fibrin and fibrinogen products. Throm Res 1989; 56:547-51.
- Urano T, Kamiya T, Sakaguchi S et al. Fibrinogenolysis and fibrinolysis in normal volunteers and patients with thrombosis after infusion of urokinase. Thromb Res 1985 ; 39:145-55.