scholarly journals Normal D-Dimer Plasma Level in a Case of Acute Thrombosis Involving Intramuscular Gastrocnemius Vein

Cureus ◽  
2021 ◽  
Author(s):  
Hany A Zaki ◽  
Amr Elmoheen ◽  
Abdallah M Elsafti Elsaeidy ◽  
Ahmed E Shaban ◽  
Eman E Shaban
Keyword(s):  
Plasma Level ◽  
Acute Thrombosis ◽  
D Dimer

scholarly journals INCREASED PLASMA LEVEL OF D-DIMER AS A MARKER OF HIGH ARTERIAL THROMBOSIS RISK

2008 ◽  
Vol 4 (4) ◽  
pp. 80-84
Author(s):  
N. V. Furman ◽  
N. F. Puchinjan ◽  
O. M. Ansimova ◽  
P. J. Dovgalevsky
Keyword(s):  
Plasma Level ◽  
Arterial Thrombosis ◽  
Thrombosis Risk ◽  
D Dimer

PLASMA CROSSLINKED FIBRIN DEGRADATION PRODUCTS FRACTION D (D-DIMER) IN PATIENTS UNDERGOING ELECTIVE MAJOR ABDOMINAL SURGERY AND IN HEALTHY VOLUNTEERS

1987 ◽  
Author(s):  
O Hauch ◽  
H Nerstrøm ◽  
T R Kølle ◽  
L N Jørgensen ◽  
P Wille-Jørgensen ◽  
...  
Keyword(s):  
Plasma Level ◽  
Abdominal Surgery ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Healthy Volunteers ◽  
Screening Test ◽  
Degradation Products ◽  
Blood Samples ◽  
Before And After ◽  
D Dimer

An increased plasma level of D-dimer has been suggested as an indicator of postoperative thromboembolism (TE). We studied the D-dimer level in patients undergoing major elective abdominal surgery and in healthy volunteers to evaluate a possible value of D-dimer as a screening test for TE. 18 patients and 5 healthy volunteers were studied. The patients received low molecular weight heparin (Logiparin TM) subcutaneously once . daily for 7 days. The 125 I-fibrinogen uptake test (FUT) was done in all patients. Blood samples were taken preoperatively, postoperatively and on the postoperative day 1, 3, 4, 5 and 6. The volunteers had blood samples taken before and 4 hours after subcutaneous Logiparin injection. D-dimer was assayed by enzyme-immunoassay (Boehringer Mannheim, Elisa D-dimer, Cat.no. 998117). Results are given as median with 95% confidence limits in brackets.One patient developed deep venous thrombosis verified by phlebography. Two patients had abnormal FUT but normal phlebography. The plasma level for D-dimer in the 15 patients with normal FUT was 500 ng/ml (300-800) preoperatively. The D-dimer level increased postoperatively to 1700 ng/ml (900-3300) (p < 0.001). The following days the D-dimer level increased steadily to 4800 ng/ml (2600-6800) 6 days postoperatively. The plasma level of D-dimer in the volunteers were less than 110 ng/ml both before and after injection of Logiparin. The plasma level of D-dimer in the patient with deep venous thrombosis and the 2 patients with abnormal FUT were within the range of the patients with normal FUT.The postoperative D-dimer level was as high as that reported in patients with diagnosed thromboembolism.In conclusion, the D-dimer test does not seem to be a potential screening test for postoperative thromboembolism.

Elevation of Serum CA 125 and D-Dimer Levels associated with Rupture of Ovarian Endometrioma

2007 ◽  
Vol 22 (3) ◽  
pp. 203-205 ◽  
Author(s):  
P. Uharček ◽  
M. Mlynček ◽  
J. Ravinger
Keyword(s):  
Plasma Level ◽  
Acute Abdominal Pain ◽  
Pelvic Mass ◽  
Sharp Decrease ◽  
High Serum ◽  
Ca 125 ◽  
High Serum Concentration ◽  
Ovarian Endometrioma ◽  
Large Ovarian Cyst ◽  
D Dimer

Background Patients with endometriosis rarely have a serum CA 125 concentration >100 IU/mL. A raised plasma level of D-dimer indicates active fibrinolysis, either secondary to clot formation or primarily activated. This condition is seldom diagnosed in patients with endometriosis. Case report A 53-year-old woman was referred to our institution for acute abdominal pain. Laparoscopic surgery revealed a large ovarian cyst with rupture on the left side. Preoperative laboratory tests detected high serum CA 125 and D-dimer levels. Adnexectomy was performed, resulting in a sharp decrease in serum CA 125 and D-dimer concentration. We describe the clinical course of the patient. Conclusion Rupture of a large ovarian endometrioma can lead to a high serum concentration of CA 125, a condition which, in addition to the detected pelvic mass, may mimic a malignant process. The increased D-dimer plasma level indicated that a ruptured endometriotic cyst can induce coagulation reactions.

scholarly journals Albumin Infusion in Critically Ill COVID-19 Patients: Hemodilution and Anticoagulation

2021 ◽  
Vol 22 (13) ◽  
pp. 7126
Author(s):  
Giuliano Ramadori
Keyword(s):  
Amino Acids ◽  
Extracellular Matrix ◽  
Plasma Level ◽  
Critically Ill ◽  
Acute Phase ◽  
Phase Reaction ◽  
Oncotic Pressure ◽  
Albumin Infusion ◽  
Coagulation Proteins ◽  
D Dimer

Hypercoagulation is one of the major risk factors for ICU treatment, mechanical ventilation, and death in critically ill patients infected with SARS-CoV-2. At the same time, hypoalbuminemia is one risk factor in such patients, independent of age and comorbidities. Especially in patients with severe SARS-CoV-2-infection, albumin infusion may be essential to improve hemodynamics and to reduce the plasma level of the main marker of thromboembolism, namely, the D-dimer plasma level, as suggested by a recent report. Albumin is responsible for 80% of the oncotic pressure in the vessels. This is necessary to keep enough water within the systemic circulatory system and for the maintenance of sufficient blood pressure, as well as for sufficient blood supply for vital organs like the brain, lungs, heart, and kidney. The liver reacts to a decrease in oncotic pressure with an increase in albumin synthesis. This is normally possible through the use of amino acids from the proteins introduced with the nutrients reaching the portal blood. If these are not sufficiently provided with the diet, amino acids are delivered to the liver from muscular proteins by systemic circulation. The liver is also the source of coagulation proteins, such as fibrinogen, fibronectin, and most of the v WF VIII, which are physiological components of the extracellular matrix of the vessel wall. While albumin is the main negative acute-phase protein, fibrinogen, fibronectin, and v WF VIII are positive acute-phase proteins. Acute illnesses cause the activation of defense mechanisms (acute-phase reaction) that may lead to an increase of fibrinolysis and an increase of plasma level of fibrinogen breakdown products, mainly fibrin and D-dimer. The measurement of the plasma level of the D-dimer has been used as a marker for venous thromboembolism, where a fourfold increase of the D-dimer plasma level was used as a negative prognostic marker in critically ill SARS-CoV-2 hospitalized patients. Increased fibrinolysis can take place in ischemic peripheral sites, where the mentioned coagulation proteins can become part of the provisional clot (e.g., in the lungs). Although critically ill SARS-CoV-2-infected patients are considered septic shock patients, albumin infusions have not been considered for hemodynamic resuscitation and as anticoagulants. The role of coagulation factors as provisional components of the extracellular matrix in case of generalized peripheral ischemia due to hypoalbuminemia and hypovolemia is discussed in this review.

scholarly journals Circulating Endothelial Cells Are Increased in Post-Thrombotic Syndrome Patients

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 4997-4997
Author(s):  
Mariane Cristina Flores-Nascimento ◽  
Bruna M Mazetto ◽  
Isadora Custódio ◽  
Fernanda Loureiro de Andrade Orsi ◽  
Joyce M Annichino-Bizzacchi
Keyword(s):  
Endothelial Cells ◽  
Conflicts Of Interest ◽  
Clinical Signs ◽  
Lower Limbs ◽  
Circulating Endothelial Cells ◽  
Healthy Controls ◽  
Acute Thrombosis ◽  
Angiogenic Potential ◽  
Post Thrombotic Syndrome ◽  
D Dimer

Abstract BACKGROUND: Post-thrombotic syndrome (PTS) is a common complication presented by patients with lower limbs deep vein thrombosis (DVT) that is characterized by pain, edema, cramps, itching, paresthesia, hyperpigmentation, and/or wound. PTS results in significant disability, and patients with severe degrees have a quality of life comparable to patients with cancer. From 20-50% of proximal DVT patients develop PTS despite optimal anticoagulant therapy, and between 5 to 10% of them present severe PTS. The diagnosis is based on clinical signs and several clinical classifications have been applied to graduate its severity, whereas the ISTH recommends the use of Villalta scale. PTS physiopathology remains unclear, but the inflammatory response to acute thrombosis, as well as to the fibrosis of venous valves and walls, seem to play an important role. Circulating endothelial cells (CEC) are infrequently detected cells derived from vascular wall or recruited from bone marrow. They have been related to hemostasis, platelet and leukocytes interaction to the vessel wall, and endothelial injury. Increased numbers of CEC are observed in ischemia, vascular trauma and have been associated to angiogenic potential. The aim of this study was to analyze CEC numbers in patients with a history of previous DVT and PTS, comparing them with DVT patients without PTS and healthy controls. We also aimed to compare CEC levels among patients with different degrees of PTS severity. Plasma D-dimer and serum IL8 levels were also determined, respectively by turbidimetric and nephelometric methods. PATIENTS AND METHODS: CEC percentage were determined in PTS patients (N=19), which were subdivided according to their score on Villalta scale; DVT patients with no post-thrombotic syndrome (N=9) and healthy controls (N=19). PTS patients and controls were matched by gender, ethnic origin and age ±5 years, and were also included. Blood (20mL) were collected in EDTA vacuum tubes, and 100μL of whole blood (with leukocyte counting between 5-10x103/μL) were used on flow cytometry analyzes. Different antibodies were included in order to better detect CEC, and two different panels were applied (panel 1: CD45-, CD144+, CD31+, CD133-; panel 2: CD45-, anti-VEGFR2+, CD31+, CD133-). RESULTS: Patients with PTS presented higher percentage of CEC, comparing to the other groups. Mild PTS patients presented higher levels of CEC using both panels in comparison to patients without PTS (P= 0.015, P= 0.019 respectively) as well as to CTR (P= 0.077, P= 0.040 respectively). The moderate+severe PTS patients presented higher levels of CEC using panel 2 both in comparison to patients without PTS (P= 0.008) and CTR (P= 0.013). CD144+ cells were slightly increased in moderate+severe PTS patients comparing to patients without PTS (P= 0.054). Both IL8 (med= 21.85 vs med=13.84 pg/mL; P=0.011) and D-dimer (med= 0.475 vs med= 0.29mg/L; P=0.044) were increased in PTS patients in comparison to patients without PTS, respectively. As CEC could eventually be derived from the residual venous thrombosis (RVT), we also dichotomized patients between those with and without RVT. The levels of CEC were similar between patients with or without RVT. CONCLUSIONS: Our results suggested that PTS may be associated with higher CEC levels. It is believed that CEC has angiogenic properties and that they may be increased on oxidative stress situations. In this context, our findings may suggest that CEC takes part on vascular-mediated PTS pathophysiology. Also the higher levels of D-dimer and IL8 may indicate that PTS patients were experiencing a pro-inflammatory condition. Disclosures No relevant conflicts of interest to declare.

Accuracy of Magnetic Resonance Direct Thrombus Imaging (MRDTI) As a Novel Tool in the Diagnosis of Acute Ipsilateral Recurrent Deep Vein Thrombosis

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 395-395
Author(s):  
Melanie Tan ◽  
Gerben C Mol ◽  
Marcel A Van de Ree ◽  
Cornelis J Van Rooden ◽  
Robin E Westerbeek ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Magnetic Resonance ◽  
Ultrasound Examination ◽  
Kappa Statistics ◽  
Acute Thrombosis ◽  
Vein Thrombosis ◽  
Thrombus Imaging ◽  
Recurrent Deep Vein Thrombosis ◽  
Deep Vein ◽  
D Dimer

Abstract Abstract 395 Background Accurate diagnostic assessment of suspected acute ipsilateral recurrent deep vein thrombosis (DVT) is of high clinical importance, however discriminating residual thrombosis from acute recurrent DVT may be challenging. It is known that in 32% of the patients with a suspected acute ipsilateral recurrent DVT the ultrasound examination are non-conclusive. Despite this, patients were treated with indefinite anticoagulant therapy, indicating overtreatment in this group of patients (Tan M et al. J Thromb Haemost 2010). A non-invasive MR technique (Magnetic Resonance Direct Thrombus Imaging (MRDTI), without need for intravenous contrast agent, showed high sensitivity and specificity for diagnosing a first acute DVT (Fraser et al Ann Intern Med 2002). Furthermore the high signal associated with acute thrombosis was not detected 6 months after the initial acute thrombosis, making MRDTI potential relevant for distinguishing a recurrent DVT from a residual thrombosis (Westerbeek RE et al J Thromb Haemost 2008). This study evaluated the accuracy of MRDTI in patients with an acute ipsilateral recurrent DVT and patients with residual thrombosis. Patients/Methods In total 84 patients were enrolled. Of these, 42 consecutive patients had an acute ipsilateral recurrent DVT according to the current ultrasound examination standards in combination with a positive D-dimer test (≥ 500 μg/L); all patients were treated with anticoagulants. Furthermore, 42 patients were without acute signs and symptoms, however had a residual thrombosis on ultrasound examination in combination with a negative D-dimer test (< 500 μg/L). All patients received a MR examination within 48 hours of presentation. MR images were assessed in a blinded fashion by two radiologists. Sensitivity, specificity and interobserver variability were calculated. Results The images of two patients with ipsilateral recurrent DVT were not interpretable, one patient had a knee prosthesis that gave artifacts and in the other patient not the venous system of interest was imaged. The images of 40 patients with an ipsilateral recurrent DVT and of 42 patients with residual thrombosis were fully interpretable. Sensitivity was 86% (95% CI, 71 –94%) and specificity was 100% (95% CI, 89–100%) for MRDTI by the first observer; sensitivity was 88% (95% CI, 74–96%) and specificity was 100% (89–100%) by the second observer. The interobserver agreement between both observers was excellent, with a kappa statistics of 0.97 (95% CI, 0.92 – 1.0). Conclusion Our study shows reasonable sensitivity and very good specificity figures with an excellent observer agreement for imaging an ipsilateral recurrent DVT and residual thrombosis with MRDTI. The sensitivity is somewhat lower than expected; a reason could be that patients with inconclusive ultrasounds were considered as acute recurrent thrombosis by the attending physician, while in fact they had a residual thrombosis. We conclude that MRDTI has good potential in distinguishing a residual thrombosis from an acute recurrent DVT and could therefore be of high value for the diagnosis of patients with suspected acute ipsilateral recurrent DVT. This should however be further evaluated in a management outcome study in which treatment decisions are based on the results of MR. Acknowledgment This study was supported by the Netherlands Heart Foundation (grant no. 2007B146) Disclosures: No relevant conflicts of interest to declare.

Diagnostic potential of plasma microRNA signatures in patients with deep-vein thrombosis

2016 ◽  
Vol 116 (08) ◽  
pp. 328-336 ◽  
Author(s):  
Xiao Wang ◽  
Kristina Sundquist ◽  
Johan L. Elf ◽  
Karin Strandberg ◽  
Peter J. Svensson ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Plasma Level ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Plasma Samples ◽  
Entire Cohort ◽  
Vein Thrombosis ◽  
Diagnostic Potential ◽  
Deep Vein ◽  
D Dimer

SummaryFor excluding deep-vein thrombosis (DVT), a negative D-dimer and low clinical probability are used to rule out DVT. Circulating microRNAs (miRNAs) are stably present in the plasma, serum and other body fluids. Their diagnostic function has been investigated in many diseases but not in DVT. The aims of present study were to assess the diagnostic ability of plasma miRNAs in DVT and to examine their correlation with known markers of hypercoagulability, such as D-dimer and APC-PCI complex. Plasma samples were obtained from 238 patients (aged 16–95 years) with suspected DVT included in a prospective multicentre management study (SCORE). We first performed miRNA screening of plasma samples from three plasma pools containing plasma from 12 patients with DVT and three plasma pools containing plasma from 12 patients without DVT using a microRNA Ready-to-use PCR Panel comprising 742 miRNA primer sets. Thirteen miRNAs that differentially expressed were further investigated by quantitative real-time (qRT)-PCR in the entire cohort. The plasma level of miR-424–5p (p=0.01) were significantly higher, whereas the levels of miR-136–5p (p=0.03) were significantly lower in DVT patients compared to patients without DVT. Receiver-operating characteristic curve analysis showed the area under the curve (AUC) values of 0.63 for miR-424–5p and 0.60 for miR-136–5p. The plasma level of miR-424–5p was associated with both D-dimer and APC-PCI complex levels (p<0.0001 and p=0.001, respectively). In conclusions, these findings indicate that certain miRNAs are associated with DVT and markers of hypercoagulability, though their diagnostic abilities are probably too low.Supplementary Material to this article is available online at www.thrombosis-online.com.

scholarly journals Markers of activated coagulation and their usefulness in the clinical laboratory

1996 ◽  
Vol 42 (5) ◽  
pp. 664-669 ◽  
Author(s):  
A Tripodi ◽  
P M Mannucci
Keyword(s):  
Prospective Studies ◽  
Clinical Studies ◽  
Clinical Laboratory ◽  
Enzyme Inhibitor ◽  
Anticoagulant Treatment ◽  
Coagulation Activation ◽  
Thrombotic Risk ◽  
Acute Thrombosis ◽  
Activation Peptides ◽  
D Dimer

Abstract Currently, information on hypercoagulability can be achieved directly--through measuring the enzymatic forms of coagulation zymogens generated during coagulation activation--or indirectly--through measuring the activation peptides generated when zymogens are activated or the enzyme-inhibitor complexes formed by inhibition of the enzymes by their plasmatic inhibitors. On the basis of published results, markers of activated coagulation are considered useful for investigating mechanisms that regulate hemostasis. They can also be used to better characterize patients at increased thrombotic risk. However, they should be considered indices of hypercoagulability, not of the risk of thrombosis, until prospective studies can demonstrate that alterations of these markers can predict the occurrence of thrombosis. For diagnosing acute thrombosis, their usefulness is questionable; they are less effective than markers of fibrinolysis activation such as the D-dimer. Finally, their use to monitor anticoagulant treatment is still premature and needs investigation in well-designed clinical studies.

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