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Lab Manual for UCSF Clinical Laboratories

Lab Manual for SFGH

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FIBRIN D DIMER (FDD)

Item Value
Approval req'd? no (except requests for more than one test per patient per 24 hours)
Available Stat? No
Test code FDDA
Performed by? Hematology
Sendout? no
Price range $$
In House Availability Emergency Department: 24 hours/7 days a week. All other locations: 7 days a week, 8 am – 11 pm.
Principle Quantitative immunoturbidimetric method on an automated system (STA-Liatest, Diagnostica Stago, Parisippany, NJ).
Interpretation Considerations for using D-dimer values to assist with VTE exclusion:

VTE, i.e., deep venous thrombosis (DVT) and pulmonary embolism (PE) may be excluded by quantitative FDD measuremnt in outpatients with adequately low clinical probability of these conditions. In this setting, and using a reference range cutoff of 500 ng/mL FEU, as adopted by SFGH Clin Lab, studies reported the sensitivity of the Liatest for VTE diagnosis at 98-100%, with a specificity of 21-54%. Because of the low specificity of the assay (many conditions other than VTE, including trauma, malignancy, and liver disease may cause elevated D-dimers), D-dimer values < 500 ng/mL FEU are useful for excluding VTE, while values ≥ 500 ng/mL are not diagnostic for VTE.

The performance of D-dimer testing for excluding VTE when there is high clinical probability for DVT or PE has not been well studied, and use of D-dimer testing in this setting is not recommended.

Studies have shown that up to 96% of inpatients have D-dimer values ≥ 500 ng/mL FEU; D-dimer testing is therefore not recommended for assistance with VTE exclusion in this patient population.

D-dimer testing for aiding in the diagnosis of disseminated intravascular coagulation (DIC):
D-dimer values < 500 ng/mL FEU argue against DIC, and D-dimer values in established DIC are generally much higher. However, no D-dimer threshold for support of DIC diagnosis has been established.

Container type citrate blue top tube
Amount to Collect Full tube (2.7 mL blood, pediatric: 1.8 mL)
Collection Instructions See Coagulation Procedures for instructions on collecting coagulation specimens.
Sample type citrated plasma
Normal range < 500 ng/mL FEU
Synonyms FDD; D Dimer;
Stability 4 hours at room temperature.
Interferences Visibly hemolyzed, icteric, lipemic, or otherwise discolored or cloudy plasma. Such specimens will not be accepted for D-dimer testing, as falsely low results may be obtained.
Additional information Exclusion of Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE) and testing for incipient or ongoing thrombotic processes.
References Ghanima et al. Br. J. Haematol 2005;132,210-215.
CPT coding 85379
Last Updated 5/29/2015 8:43:07 AM
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