A Case of False Elevation of D-Dimer and Elimination Methods.


Journal

Clinical laboratory
ISSN: 1433-6510
Titre abrégé: Clin Lab
Pays: Germany
ID NLM: 9705611

Informations de publication

Date de publication:
01 Jun 2024
Historique:
medline: 13 6 2024
pubmed: 13 6 2024
entrez: 13 6 2024
Statut: ppublish

Résumé

There are many methods for the detection of D-dimer in clinical laboratories. Immunoturbidimetric assays are widely used because of its high sensitivity and specificity [1-3]. However, this method may be affected by the interference of rheumatoid factor (RF), heterophilic antibodies, and other unknown proteins, and its falsity will increase, thus affecting clinical diagnosis. This paper reports the cause analysis of a case of spurious D-dimer increase and four corresponding elimination methods: double dilution of the original specimen, detection of fibrin degradation product (FDP) level, addition of heterophilic blocking reagent, and comparison between different instruments. It was confirmed that there were special antibodies in the patient's body by four methods, which had non-specific reactions with D-dimer reagents, resulting in false increases of results. When the coagulation function results of patients show isolated increases in D-dimer, or the results are inconsistent with clinical symptoms, laboratory personnel should consider the possibility of interference factors, and conduct effective treatment to obtain correct test results, and thus reduce the occurrence of medical adverse events caused by inaccurate test results.

Sections du résumé

BACKGROUND BACKGROUND
There are many methods for the detection of D-dimer in clinical laboratories. Immunoturbidimetric assays are widely used because of its high sensitivity and specificity [1-3]. However, this method may be affected by the interference of rheumatoid factor (RF), heterophilic antibodies, and other unknown proteins, and its falsity will increase, thus affecting clinical diagnosis.
METHODS METHODS
This paper reports the cause analysis of a case of spurious D-dimer increase and four corresponding elimination methods: double dilution of the original specimen, detection of fibrin degradation product (FDP) level, addition of heterophilic blocking reagent, and comparison between different instruments.
RESULTS RESULTS
It was confirmed that there were special antibodies in the patient's body by four methods, which had non-specific reactions with D-dimer reagents, resulting in false increases of results.
CONCLUSIONS CONCLUSIONS
When the coagulation function results of patients show isolated increases in D-dimer, or the results are inconsistent with clinical symptoms, laboratory personnel should consider the possibility of interference factors, and conduct effective treatment to obtain correct test results, and thus reduce the occurrence of medical adverse events caused by inaccurate test results.

Identifiants

pubmed: 38868870
doi: 10.7754/Clin.Lab.2023.231229
doi:

Substances chimiques

Fibrin Fibrinogen Degradation Products 0
fibrin fragment D 0
Antibodies, Heterophile 0
Rheumatoid Factor 9009-79-4

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Auteurs

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Classifications MeSH